245 results on '"Masayoshi Oikawa"'
Search Results
2. Associations of the fibrosis‐4 index with left atrial low‐voltage areas and arrhythmia recurrence after catheter ablation: cardio‐hepatic interaction in patients with atrial fibrillation
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Shinya Yamada, Takashi Kaneshiro, Minoru Nodera, Kazuaki Amami, Takeshi Nehashi, Masayoshi Oikawa, Takayoshi Yamaki, Kazuhiko Nakazato, Takafumi Ishida, and Yasuchika Takeishi
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ablation ,atrial fibrillation ,cardio‐hepatic interaction ,fibrosis‐4 index ,low‐voltage areas ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background The relationship between liver fibrosis and left atrial (LA) remodeling in atrial fibrillation (AF) remains uncertain. We examined the associations between the fibrosis‐4 (FIB4) index, an indicator of liver fibrosis, and both LA low‐voltage areas (LVAs) on electroanatomic mapping and AF recurrence postablation. Methods We recruited 343 patients who underwent radiofrequency catheter ablation (RFCA) or cryoballoon ablation (CBA) for AF. First, the association between the FIB4 index and LA LVAs (5 cm2) compared to those without. Additionally, the quantitative size of LVAs showed a positive correlation with the FIB4 index (R = .642, p
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- 2024
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3. Geriatric Nutritional Risk Index predicts bleeding event in patients with heart failure
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Yu Sato, Akiomi Yoshihisa, Yuji Nozaki, Himika Ohara, Yukiko Sugawara, Satoshi Abe, Tomofumi Misaka, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Kazuhiko Nakazato, and Yasuchika Takeishi
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Malnutrition ,Bleeding ,Haemorrhage ,Heart failure ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims We aimed to elucidate the association between malnutrition and the occurrence of bleeding events in patients with heart failure. Methods and results We evaluated the nutritional status of patients with heart failure [n = 2044, median (inter‐quartile range) age 69.0 (59.0–78.0) years, 1209 (59.1%) males] using the Geriatric Nutritional Risk Index (GNRI). The primary endpoint was a composite of bleeding events such as haemorrhagic stroke or gastrointestinal bleeding. According to the survival classification and regression tree analysis, the accurate cut‐off point of GNRI for predicting the primary endpoint was 106.2. We divided the patients into two groups based on GNRI levels: high GNRI group (GNRI ≥ 106.2, n = 606, 29.6%) and low GNRI group (GNRI
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- 2024
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4. Hepatic Venous Stasis Index Reflects Hepatic Congestion and Predicts Adverse Outcomes in Patients With Heart Failure
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Himika Ohara, Akiomi Yoshihisa, Shinji Ishibashi, Mitsuko Matsuda, Yukio Yamadera, Yukiko Sugawara, Yasuhiro Ichijo, Yu Sato, Tomofumi Misaka, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, and Yasuchika Takeishi
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heart failure ,hemodynamics ,hepatic vein ,liver ,prognosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background It has been reported that the hepatic vein waveforms determined by abdominal ultrasonography can assess hepatic congestion in patients with heart failure (HF). However, the parameter that quantifies hepatic vein waveforms has not been established. We suggest the hepatic venous stasis index (HVSI) as the novel indicator to evaluate hepatic congestion quantitatively. To examine the clinical significance of HVSI in patients with HF, we aimed to clarify the associations of HVSI with the parameters of cardiac function and right heart catheterization, as well as that with prognosis, in patients with HF. Methods and Results We performed abdominal ultrasonography, echocardiography, and right heart catheterization in patients with HF (n=513). The patients were divided into 3 groups based on HVSI as follows: HVSI 0 (HVSI=0, n=253), low HVSI (HVSI 0.01–0.20, n=132), and high HVSI (HVSI>0.20, n=128). We examined the associations of HVSI with parameters of cardiac function and right heart catheterization and followed up for cardiac events defined as cardiac death or worsening HF. There was a significant increase in level of B‐type natriuretic peptide, inferior vena cava diameter, and mean right atrial pressure with increasing HVSI. During the follow‐up period, cardiac events occurred in 87 patients. In the Kaplan–Meier analysis, cardiac event rate increased across increasing HVSI (log‐rank, P=0.002). Conclusions HVSI assessed by abdominal ultrasonography reflects hepatic congestion and right‐sided HF and is associated with adverse prognosis in patients with HF.
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- 2023
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5. A Case of Giant Goiter Associated with Airway Stenosis Caused by Long-Term Intravenous Epoprostenol Therapy for Idiopathic Pulmonary Arterial Hypertension
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Kazuto Nishiura, Kazuhiko Nakazato, Tetsuro Yokokawa, Yoshinori Suzuki, Yuta Kurosawa, Kento Wada, Takeshi Shimizu, Masayoshi Oikawa, Atsushi Kobayashi, Koichi Sugimoto, Norshalena Shakespear, Yuko Hashimoto, and Yasuchika Takeishi
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idiopathic pulmonary arterial hypertension ,epoprostenol ,prostaglandin I2 ,giant goiter ,airway stenosis ,Medicine - Abstract
Idiopathic pulmonary arterial hypertension is a progressive and life-threatening disease with pulmonary vasculature remodeling, leading to right-sided heart failure. Epoprostenol (prostaglandin I2) is highly recommended for patients with severe pulmonary arterial hypertension (PAH) categorized by the World Health Organization as functional class III or IV. It has been reported that prostaglandin I2 analogs can cause thyroid gland swelling and abnormal thyroid function. A 34-year-old woman was diagnosed with idiopathic pulmonary arterial hypertension and started receiving continuous intravenous epoprostenol. Three years after starting epoprostenol, she began complaining of neck swelling and was diagnosed with Graves’ disease. The patient’s thyroid function was controlled by thiamazole and levothyroxine; nevertheless, her thyroid gland enlargement worsened as the epoprostenol dose was titrated. After 20 years, she developed respiratory failure with a giant goiter leading to airway stenosis, and she passed away. The pathological autopsy confirmed a massive goiter associated with hyperthyroidism and airway stenosis. We experienced a case of idiopathic pulmonary hypertension with a giant goiter and airway stenosis after long-term intravenous epoprostenol therapy.
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- 2023
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6. Impaired brain activity in patients with persistent atrial fibrillation assessed by near-infrared spectroscopy and its changes after catheter ablation
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Akiomi Yoshihisa, Soichi Kono, Takashi Kaneshiro, Yasuhiro Ichijo, Tomofumi Misaka, Shinya Yamada, Masayoshi Oikawa, Itaru Miura, Hirooki Yabe, and Yasuchika Takeishi
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Medicine ,Science - Abstract
Abstract Although the prevalence of cognitive impairment and depression is higher in patients with atrial fibrillation (AF) than in the general population, the mechanism has not been fully examined and impact of catheter ablation (CA) of AF also remains unclear. Recently, the development of near-infrared spectroscopy (NIRS) has enabled noninvasive measurements of regional cerebral blood volume and brain activity, in terms of cerebral oxyhemoglobin in the cerebral cortex. We assessed brain activities by NIRS, depressive symptoms by the Center for Epidemiologic Studies Depression Scale (CES-D) and cognitive function by Mini-Mental State Examination (MMSE). We then compared the results between AF patients (paroxysmal AF n = 18 and persistent AF n = 14) and control subjects (n = 29). Next, we also followed up persistent AF patients who kept sinus rhythm at 3 months after CA (n = 8) and measured their brain activities using NIRS, CES-D and MMSE after CA to investigate the associations of changes in brain activities with changes in both CES-D and MMSE. Our results showed that (1) frontal and temporal brain activities were lower in patients with persistent AF than both in control subjects and paroxysmal AF patients (P
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- 2022
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7. Serum TRACP5b, a Marker of Bone Resorption, Is Associated With Adverse Cardiac Prognosis in Hospitalized Patients With Heart Failure
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Satoshi Abe, MD, PhD, Akiomi Yoshihisa, MD, PhD, Yasuhiro Ichijo, MD, PhD, Yusuke Kimishima, MD, PhD, Tetsuro Yokokawa, MD, PhD, Tomofumi Misaka, MD, PhD, Takamasa Sato, MD, PhD, Masayoshi Oikawa, MD, PhD, Atsushi Kobayashi, MD, PhD, Takashi Kaneshiro, MD, PhD, Kazuhiko Nakazato, MD, PhD, and Yasuchika Takeishi, MD, PhD
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Tartrate-resistant acid phosphatase type 5b (TRACP5b) is derived from osteoclasts, and has been used as a marker of osteoporosis (bone resorption). Although heart failure (HF) is associated with catabolic bone remodelling, serum TRACP5b levels have not been rigourously examined in patients with HF. Methods: We conducted a prospective observational study of 688 decompensated HF patients who had been discharged and whose TRACP5b had been measured. These patients were divided into tertiles on the basis of serum TRACP5b levels: first (TRACP5b < 316 mU/dL, n = 229), second (TRACP5b 316-489 mU/dL, n = 229), and third (TRACP5b ≥ 490 mU/dL, n = 230). We compared the patient baseline characteristics, exercise capacity, and their postdischarge prognosis, including cardiac mortality and cardiac events such as cardiac death and worsening HF. Results: Age was significantly higher, and prevalence of female sex and anemia was significantly higher in the third tertile than in the first and second tertiles (P < 0.05, respectively). Circulating TRACP5b levels were correlated with peak breath-by-breath oxygen consumption, but not with left ventricular ejection fraction. In the Kaplan-Meier analysis (mean follow-up, 426 days), cardiac mortality and cardiac event rates progressively increased from the first to the third tertiles (P < 0.05, respectively). In the multivariable Cox proportional hazard analysis, the third tertile was an independent predictor of cardiac mortality and cardiac events (cardiac mortality hazard ratio, 2.493; P = 0.040; cardiac events hazard ratio, 1.687; P = 0.030). Conclusions: High serum levels of TRACP5b, a marker of bone resorption, are associated with high cardiac mortality and cardiac events, accompanied by impaired exercise capacity. Résumé: Introduction: La TRACP5b (de l’anglais, tartrate-resistant acid phosphatase type 5b, soit l’isoforme 5 b de la phosphatase acide résistante au tartrate) qui est dérivée des ostéoclastes a été utilisée comme marqueur de l’ostéoporose (la résorption de l’os). Bien que l’insuffisance cardiaque (IC) soit associée au remodelage osseux catabolique, les concentrations sériques de TRACP5b n’ont pas été rigoureusement examinées chez les patients atteints d’IC. Méthodes: Nous avons mené une étude prospective observationnelle auprès de 688 patients atteints d’IC décompensée qui avaient obtenu leur sortie de l’hôpital et pour lesquels nous avions les mesures de TRACP5b. Nous avons réparti ces patients en tertiles en fonction des concentrations sériques de TRACP5b : le premier (TRACP5b < 316 mU/dL, n = 229), le deuxième (TRACP5b 316-489 mU/dL, n = 229) et le troisième (TRACP5b ≥ 490 mU/dL, n = 230). Nous avons comparé les caractéristiques initiales des patients, leur capacité à l’effort et leur pronostic après la sortie de l’hôpital, à savoir la mortalité d’origine cardiaque et les événements cardiaques tels que la mort cardiaque et l’aggravation de l’IC. Résultats: L’âge était significativement plus élevé, et la prévalence du sexe féminin et de l’anémie était significativement plus élevée dans le troisième tertile que dans les premier et deuxième tertiles (P < 0,05, respectivement). Les concentrations circulantes de TRACP5b corrélaient avec la consommation d’oxygène maximale « respiration par respiration », mais non avec la fraction d’éjection ventriculaire gauche. Dans l’analyse de Kaplan-Meier (durée moyenne de suivi, 426 jours), les taux de mortalité d’origine cardiaque et d’ événements cardiaques augmentaient progressivement du 1er tertile au 3e tertile (P < 0,05, respectivement). Dans l’analyse multivariable selon le modèle des risques proportionnels de Cox, le 3e tertile était un prédicteur indépendant de la mortalité d’origine cardiaque et des événements cardiaques (rapport de risque de mortalité d’origine cardiaque, 2,493; P = 0,040; rapport de risque d’événements cardiaques, 1,687; P = 0,030). Conclusions: Les concentrations sériques élevées de TRACP5b, un marqueur de la résorption de l’os, sont associées à la hausse des taux de mortalité d’origine cardiaque et d’ événements cardiaques, accompagnés de la diminution de la capacité à l’effort.
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- 2021
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8. Increases in Hepatokine Selenoprotein P Levels Are Associated With Hepatic Hypoperfusion and Predict Adverse Prognosis in Patients With Heart Failure
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Ryohei Takeishi, Tomofumi Misaka, Yasuhiro Ichijo, Shinji Ishibashi, Mitsuko Matsuda, Yukio Yamadera, Himika Ohara, Yukiko Sugawara, Yu Hotsuki, Koichiro Watanabe, Fumiya Anzai, Yu Sato, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Kazuhiko Nakazato, Akiomi Yoshihisa, and Yasuchika Takeishi
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biomarker ,heart failure ,hepatokine ,prognosis ,selenoprotein P ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Although multiorgan networks are involved in the pathophysiology of heart failure (HF), interactions of the heart and the liver have not been fully understood. Hepatokines, which are synthesized and secreted from the liver, have regulatory functions in peripheral tissues. Here, we aimed to clarify the clinical impact of the hepatokine selenoprotein P in patients with HF. Methods and Results This is a prospective observational study that enrolled 296 participants consisting of 253 hospitalized patients with HF and 43 control subjects. First, we investigated selenoprotein P levels and found that its levels were significantly higher in patients with HF than in the controls. Next, patients with HF were categorized into 4 groups according to the presence of liver congestion using shear wave elastography and liver hypoperfusion by peak systolic velocity of the celiac artery, which were both assessed by abdominal ultrasonography. Selenoprotein P levels were significantly elevated in patients with HF with liver hypoperfusion compared with those without but were not different between the patients with and without liver congestion. Selenoprotein P levels were negatively correlated with peak systolic velocity of the celiac artery, whereas no correlations were observed between selenoprotein P levels and shear wave elastography of the liver. Kaplan‐Meier analysis demonstrated that patients with HF with higher selenoprotein P levels were significantly associated with increased adverse cardiac outcomes including cardiac deaths and worsening HF. Conclusions Liver‐derived selenoprotein P correlates with hepatic hypoperfusion and may be a novel target involved in cardiohepatic interactions as well as a useful biomarker for predicting prognosis in patients with HF.
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- 2022
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9. Persistent Hypochloremia Is Associated with Adverse Prognosis in Patients Repeatedly Hospitalized for Heart Failure
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Yuji Nozaki, Akiomi Yoshihisa, Yu Sato, Himika Ohara, Yukiko Sugawara, Satoshi Abe, Tomofumi Misaka, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Kazuhiko Nakazato, and Yasuchika Takeishi
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hypochloremia ,serum chloride ,heart failure ,cardiac death ,all-cause death ,Medicine - Abstract
Background: Hypochloremia reflects neuro-hormonal activation in patients with heart failure (HF). However, the prognostic impact of persistent hypochloremia in those patients remains unclear. Methods: We collected the data of patients who were hospitalized for HF at least twice between 2010 and 2021 (n = 348). Dialysis patients (n = 26) were excluded. The patients were divided into four groups based on the absence/presence of hypochloremia (p < 0.001) and cardiac death (hazard ratio 3.919, p < 0.001). Conclusions: In patients with HF, prolonged hypochloremia over two hospitalizations is associated with an adverse prognosis.
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- 2023
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10. The relationship between red cell distribution width and cardiac autonomic function in heart failure
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Shinya Yamada, Akiomi Yoshihisa, Takashi Kaneshiro, Kazuaki Amami, Naoko Hijioka, Masayoshi Oikawa, and Yasuchika Takeishi
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cardiac autonomic dysfunction ,heart rate turbulence ,heart rate variability ,prognosis ,red cell distribution width ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Both increases in red cell distribution width (RDW) levels and autonomic dysfunction are considered to be correlated with worsening heart failure. However, the relation of RDW levels to autonomic function remains uncertain. We aimed to investigate the association of RDW levels in heart failure with autonomic function, evaluated by heart rate variability (HRV) and heart rate turbulence (HRT), and prognosis. Methods We studied 222 hospitalized patients with stable heart failure before discharge, and Holter recordings (HRV and HRT) were performed. Additionally, RDW levels were measured, and high RDW was defined as over 14.5%. We then divided the patients into two groups based on RDW levels: high RDW group (>14.5%, n = 92) and low RDW group (≤14.5%, n = 130). The relation of RDW to autonomic function and prognosis was assessed. Results In the high RDW group, severely impaired HRV and HRT were found compared to the low RDW group. In the linear regression analysis after the adjustment of multiple confounders, RDW levels were correlated with a low‐frequency (LF) to high‐frequency (HF) ratio and very low‐frequency (VLF) power (LF to HF ratio, β = −0.146, P = .027, and VLF power, β = −0.137, P = .041, respectively). During the observation period (median 1400 days), cardiac events (re‐hospitalization of heart failure, cardiac death or sudden death) were found in 73 (32.8%) patients. The Kaplan‐Meier analysis demonstrated that the high RDW group had a higher rate of cardiac events compared to the low RDW group (45.6% vs 23.8%, log‐rank P
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- 2020
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11. Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure
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Akiomi Yoshihisa, Koichiro Watanabe, Yu Sato, Shinji Ishibashi, Mitsuko Matsuda, Yukio Yamadera, Yasuhiro Ichijo, Tetsuro Yokokawa, Tomofumi Misaka, Masayoshi Oikawa, Atsushi Kobayashi, and Yasuchika Takeishi
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Medicine ,Science - Abstract
Abstract We aimed to clarify clinical implications of intrarenal hemodynamics assessed by intrarenal Doppler ultrasonography (IRD) and their prognostic impacts in heart failure (HF). We performed a prospective observational study, and examined IRD and measured interlobar renal artery velocity time integral (VTI) and intrarenal venous flow (IRVF) patterns (monophasic or non-monophasic pattern) to assess intrarenal hypoperfusion and congestion in HF patients (n = 341). Seven patients were excluded in VTI analysis due to unclear imaging. The patients were divided into groups based on (A) VTI: high VTI (VTI ≥ 14.0 cm, n = 231) or low VTI (VTI
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- 2020
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12. B‐type natriuretic peptide is associated with post‐discharge stroke in hospitalized patients with heart failure
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Yu Hotsuki, Yu Sato, Akiomi Yoshihisa, Koichiro Watanabe, Yusuke Kimishima, Takatoyo Kiko, Tetsuro Yokokawa, Satoshi Abe, Tomofumi Misaka, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, and Yasuchika Takeishi
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Heart failure ,B‐type natriuretic peptide ,Stroke ,CHADS2 score ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims Recently, B‐type natriuretic peptide (BNP) has been attracting attention as a predictor of stroke in patients with atrial fibrillation or those with prior stroke experience. However, the association between BNP and stroke has not been examined in patients with chronic heart failure (CHF). In the current study, we assessed whether BNP is associated with future occurrence of stroke in patients with CHF. Methods and results We prospectively studied 1803 consecutive patients who were admitted for decompensated HF and assessed the predictive value of circulating BNP levels for occurrence of post‐discharge stroke. A total of 69 (3.8%) patients experienced a stroke (the stroke group) during the post‐discharge follow‐up period of a median of 1150 days. The stroke group showed a higher CHADS2 score. With respect to past medical history, the stroke group had a higher prevalence of arterial hypertension, atrial fibrillation, prior stroke, and chronic kidney disease. Echocardiographic parameters showed no significant differences between the two groups. In contrast, BNP levels were significantly higher in the stroke group than in the non‐stroke group (452.1 vs. 222.7 pg/mL, P
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- 2020
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13. Renal Venous Stasis Index Reflects Renal Congestion and Predicts Adverse Outcomes in Patients With Heart Failure
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Himika Ohara, Akiomi Yoshihisa, Yuko Horikoshi, Shinji Ishibashi, Mitsuko Matsuda, Yukio Yamadera, Yukiko Sugawara, Yasuhiro Ichijo, Yu Hotsuki, Koichiro Watanabe, Yu Sato, Tomofumi Misaka, Takashi Kaneshiro, Masayoshi Oikawa, Atsushi Kobayashi, and Yasuchika Takeishi
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heart failure ,renal circulation ,hemodynamics ,kidney ,prognosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundIt has been recently reported that the renal venous stasis index (RVSI) assessed by renal Doppler ultrasonography provides information to stratify pulmonary hypertension that can lead to right-sided heart failure (HF). However, the clinical significance of RVSI in HF patients has not been sufficiently examined. We aimed to examine the associations of RVSI with parameters of cardiac function and right heart catheterization (RHC), as well as with prognosis, in patients with HF.MethodsWe performed renal Doppler ultrasonography, echocardiography and RHC in hospitalized patients with HF (n = 388). RVSI was calculated as follows: RVSI = (cardiac cycle time-venous flow time)/cardiac cycle time. The patients were classified to three groups based on RVSI: control group (RVSI = 0, n = 260, 67%), low RVSI group (0 < RVSI ≤ 0.21, n = 63, 16%) and high RVSI group (RVSI > 0.21, n = 65, 17%). We examined associations of RVSI with parameters of cardiac function and RHC, and followed up for cardiac events defined as cardiac death or worsening HF.ResultsThere were significant correlations of RVSI with mean right atrial pressure (mRAP; R = 0.253, P < 0.001), right atrial area (R = 0.327, P < 0.001) and inferior vena cava diameter (R = 0.327, P < 0.001), but not with cardiac index (R = −0.019, P = 0.769). During the follow-up period (median 412 days), cardiac events occurred in 60 patients. In the Kaplan–Meier analysis, the cumulative cardiac event rate increased with increasing RVSI (log-rank, P = 0.001). In the multivariate Cox proportional hazard analysis, the cardiac event rate was independently associated with RVSI (high RVSI group vs. control group: hazard ratio, 1.908; 95% confidence interval, 1.046–3.479, P = 0.035).ConclusionRVSI assessed by renal Doppler ultrasonography reflects right-sided overload and is associated with adverse prognosis in HF patients.
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- 2022
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14. D-Dimer Is a Predictive Factor of Cancer Therapeutics-Related Cardiac Dysfunction in Patients Treated With Cardiotoxic Chemotherapy
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Masayoshi Oikawa, Daiki Yaegashi, Tetsuro Yokokawa, Tomofumi Misaka, Takamasa Sato, Takashi Kaneshiro, Atsushi Kobayashi, Akiomi Yoshihisa, Kazuhiko Nakazato, Takafumi Ishida, and Yasuchika Takeishi
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cardio-oncology ,D-dimer ,cancer therapeutics-related cardiac dysfunction ,heart failure ,troponin I ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundD-dimer is a sensitive biomarker for cancer-associated thrombosis, but little is known about its significance on cancer therapeutics-related cardiac dysfunction (CTRCD).MethodsConsecutive 169 patients planned for cardiotoxic chemotherapy were enrolled and followed up for 12 months. All patients underwent echocardiography and blood test at baseline and at 3-, 6-, and 12 months.ResultsThe patients were divided into two groups based on the level of D-dimer (>1.65 μg/ml or ≦ 1.65 μg/ml) at baseline before chemotherapy: high D-dimer group (n = 37) and low D-dimer group (n = 132). Left ventricular ejection fraction (LVEF) decreased at 3- and 6 months after chemotherapy in high D-dimer group [baseline, 65.2% (62.8–71.4%); 3 months, 62.9% (59.0–67.7%); 6 months, 63.1% (60.0–67.1%); 12 months, 63.3% (58.8–66.0%), p = 0.03], but no change was observed in low D-dimer group. The occurrence of CTRCD within the 12-month follow-up period was higher in the high D-dimer group than in the low D-dimer group (16.2 vs. 4.5%, p = 0.0146). Multivariable logistic regression analysis revealed that high D-dimer level at baseline was an independent predictor of the development of CTRCD [odds ratio 3.93, 95% CI (1.00–15.82), p = 0.047].ConclusionWe should pay more attention to elevated D-dimer levels not only as a sign of cancer-associated thrombosis but also the future occurrence of CTRCD.
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- 2022
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15. Prognostic significance of premature ventricular complex burden on hospitalized patients with heart failure
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Shinya Yamada, Akiomi Yoshihisa, Takamasa Sato, Masashi Kamioka, Takashi Kaneshiro, Masayoshi Oikawa, Atsushi Kobayashi, Takafumi Ishida, and Yasuchika Takeishi
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cardiac death ,heart failure ,Holter monitoring ,premature ventricular complex ,readmission ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background The clinical significance of premature ventricular complexes (PVCs) in heart failure (HF) remains unclear. We aimed to clarify the associations of PVC burden with re‐hospitalization and cardiac death in HF patients. Methods We studied 435 HF patients (271 men, mean age 65 years). All patients were hospitalized for worsening HF. After optimal medications, echocardiography, 24 hours Holter monitoring and cardiopulmonary exercise testing were performed before discharge. The clinical characteristics and outcomes of the HF patients were investigated. Results During a median follow‐up period of 2.3 years, there were 125 (28.7%) cardiac events (re‐hospitalization due to worsening HF, fatal arrhythmias, or cardiac death). The patients with cardiac events had higher PVC burden compared to those without (median 0.374%/d [interquartile range 0.013‐1.510] vs median 0.026%/d [interquartile range 0.000‐0.534], P 0.145%/d) to be a predictive factor of cardiac events (area under the curve: 0.64). Kaplan‐Meier analysis demonstrated that cardiac events were more frequent in patients with high‐PVC burden (>0.145%/d, n = 194) compared to those with low‐PVC burden (≤0.145%/d, n = 241). Furthermore, the high‐PVC burden patients had left ventricular (LV) and atrial dilatation, reduced LV ejection fraction, and impaired exercise capacity, compared to the low‐PVC burden patients. In Cox proportional hazards analysis, high‐PVC burden was significantly associated with cardiac events with a hazard ratio of 2.028 (95% confidence interval: 1.418‐2.901, P
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- 2020
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16. Blood‐Based Epigenetic Markers of FKBP5 Gene Methylation in Patients With Dilated Cardiomyopathy
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Kento Wada, Tomofumi Misaka, Tetsuro Yokokawa, Yusuke Kimishima, Takashi Kaneshiro, Masayoshi Oikawa, Akiomi Yoshihisa, and Yasuchika Takeishi
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biomarker ,dilated cardiomyopathy ,DNA methylation ,epigenetics ,FKBP5 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Blood‐based DNA methylation patterns are linked to types of diseases. FKBP prolyl isomerase 5 (FKBP5), a protein cochaperone, is known to be associated with the inflammatory response, but the regulatory mechanisms by leukocyte FKBP5 DNA methylation in patients with dilated cardiomyopathy (DCM) remain unclear. Methods and Results The present study enrolled patients with DCM (n=31) and age‐matched and sex‐matched control participants (n=43). We assessed FKBP5 CpG (cytosine‐phosphate‐guanine) methylation of CpG islands at the 5′ side as well as putative promoter regions by methylation‐specific quantitative polymerase chain reaction using leukocyte DNA isolated from the peripheral blood. FKBP5 CpG methylation levels at the CpG island of the gene body and the promoter regions were significantly decreased in patients with DCM. Leukocyte FKBP5 and IL‐1β (interleukin 1β) mRNA expression levels were significantly higher in patients with DCM than in controls. The protein expressions of DNMT1 (DNA methyltransferase 1) and DNMT3A (DNA methyltransferase 3A) in leukocytes were significantly reduced in patients with DCM. In vitro methylation assay revealed that FKBP5 promoter activity was inhibited at the methylated conditions in response to immune stimulation, suggesting that the decreased FKBP5 CpG methylation was functionally associated with elevation of FKBP5 mRNA expressions. Histological analysis using a mouse model with pressure overload showed that FKBP5‐expressing cells were substantially infiltrated in the myocardial interstitium in the failing hearts, indicating a possible role of FKBP5 expressions of immune cells in the cardiac remodeling. Conclusions Our findings demonstrate a link between specific CpG hypomethylation of leukocyte FKBP5 and DCM. Blood‐based epigenetic modification in FKBP5 may be a novel molecular mechanism that contributes to the pathogenesis of DCM.
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- 2021
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17. Cardio-Ankle Vascular Index Reflects Impaired Exercise Capacity and Predicts Adverse Prognosis in Patients With Heart Failure
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Koichiro Watanabe, Akiomi Yoshihisa, Yu Sato, Yu Hotsuki, Fumiya Anzai, Yasuhiro Ichijo, Yusuke Kimishima, Tetsuro Yokokawa, Tomofumi Misaka, Takamasa Sato, Takashi Kaneshiro, Masayoshi Oikawa, Atsushi Kobayashi, and Yasuchika Takeishi
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cardio-ankle vascular index ,arterial stiffness ,cardiopulmonary exercise testing ,heart failure ,prognosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Aims: We aimed to assess the associations of CAVI with exercise capacity in heart failure (HF) patients. In addition, we further examined their prognosis.Methods: We collected the clinical data of 223 patients who had been hospitalized for decompensated HF and had undergone both CAVI and cardiopulmonary exercise testing.Results: For the prediction of an impaired peak oxygen uptake (VO2) of < 14 mL/kg/min, receiver-operating characteristic curve demonstrated that the cutoff value of CAVI was 8.9. In the multivariate logistic regression analysis for predicting impaired peak VO2, high CAVI was found to be an independent factor (odds ratio 2.343, P = 0.045). We divided these patients based on CAVI: the low-CAVI group (CAVI < 8.9, n = 145) and the high-CAVI group (CAVI ≥ 8.9, n = 78). Patient characteristics and post-discharge cardiac events were compared between the two groups. The high-CAVI group was older (69.0 vs. 58.0 years old, P < 0.001) and had lower body mass index (23.0 vs. 24.1 kg/m2, P = 0.013). During the post-discharge follow-up period of median 1,623 days, 58 cardiac events occurred. The Kaplan–Meier analysis demonstrated that the cardiac event rate was higher in the high-CAVI group than in the low-CAVI group (log–rank P = 0.004). The multivariate Cox proportional hazard analysis revealed that high CAVI was an independent predictor of cardiac events (hazard ratio 1.845, P = 0.035).Conclusion: High CAVI is independently associated with impaired exercise capacity and a high cardiac event rate in HF patients.
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- 2021
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18. Soluble fibrin monomer complex is associated with cardio- and cerebrovascular events in patients with heart failure
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Akiomi Yoshihisa, Yu Sato, Yusuke Kimishima, Yasuhiro Ichijo, Tetsuro Yokokawa, Tomofumi Misaka, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, Kazuhiko Nakazato, and Yasuchika Takeishi
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Heart failure ,Fibrin formation ,Hypercoagulability ,Major cardio- and cerebrovascular events ,Prognosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: A biomarker of fibrin formation, the soluble fibrin monomer complex (SFMC), is abnormally elevated in a variety of clinical situations of hypercoagulability. The aim of the present study was to examine the prognostic impact of SFMC, with regard to increased risk of major cardio- and cerebrovascular events (MACCE) and all-cause mortality, on patients with heart failure (HF). Methods and Results: We conducted a prospective observational study where we analyzed data of 723 hospitalized patients with decompensated HF who were discharged alive and whose SFMC had been measured in a stable condition prior to discharge. The patients were divided into tertiles based on SFMC levels: the first (SFMC
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- 2021
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19. Red Blood Cell Distribution Width Is a Predictive Factor of Anthracycline-Induced Cardiotoxicity
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Daiki Yaegashi, Masayoshi Oikawa, Tetsuro Yokokawa, Tomofumi Misaka, Atsushi Kobayashi, Takashi Kaneshiro, Akiomi Yoshihisa, Kazuhiko Nakazato, Takafumi Ishida, and Yasuchika Takeishi
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cardio-oncology ,anthracycline ,red blood cell distribution width ,cancer therapeutics-related cardiac dysfunction ,heart failure 2 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Red blood cell distribution width (RDW) is associated with prognosis in widespread cardiovascular fields, but little is known about relationship with the onset of cancer therapeutics-related cardiac dysfunction (CTRCD).Objectives: The purpose of this study was to assess whether RDW could predict the onset of CTRCD by anthracycline.Methods: Consequential 202 cancer patients planed for anthracycline treatment were enrolled and followed up for 12 months. The patients were divided into 2 groups based on the median value of baseline RDW before chemotherapy [low RDW group, n = 98, 13.0 [12.6–13.2]; high RDW group, n = 104, 14.9 [13.9–17.0]]. Cardiac function was assessed serially by echocardiography at baseline (before chemotherapy), as well as at 3, 6, and 12 months after chemotherapy with anthracycline.Results: Baseline left ventricular end systolic volume index and ejection fraction (EF) were similar between two groups. After chemotherapy, EF decreased at 3- and 6-month in the high RDW group [baseline, 64.5% [61.9–68.9%]; 3-month, 62.6% [60.4–66.9%]; 6-month, 63.9% [60.0–67.9%]; 12-month, 64.7% [60.8–67.0%], P = 0.04], but no change was observed in low RDW group. The occurrence of CTRCD was higher in high RDW group than in low RDW group (11.5 vs. 2.0%, P = 0.008). When we set the cut-off value of RDW at 13.8, sensitivity and specificity to predict CTRCD were 84.6 and 62.0%, respectively. Multivariable logistic regression analysis revealed that baseline RDW value was an independent predictor of the development of CTRCD [odds ratio 1.390, 95% CI [1.09–1.78], P = 0.008]. The value of net reclassification index (NRI) and integrated discrimination improvement (IDI) for detecting CTRCD reached statistical significance when baseline RDW value was added to the regression model including known risk factors such as cumulative anthracycline dose, EF, albumin, and the presence of hypertension; 0.9252 (95%CI 0.4103–1.4402, P < 0.001) for NRI and 0.1125 (95%CI 0.0078–0.2171, P = 0.035) for IDI.Conclusions: Baseline RDW is a novel parameter to predict anthracycline-induced CTRCD.
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- 2020
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20. Clinical Implications of Hepatic Hemodynamic Evaluation by Abdominal Ultrasonographic Imaging in Patients With Heart Failure
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Akiomi Yoshihisa, Shinji Ishibashi, Mitsuko Matsuda, Yukio Yamadera, Yasuhiro Ichijo, Yu Sato, Tetsuro Yokokawa, Tomofumi Misaka, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, and Yasuchika Takeishi
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hemodynamics ,liver ,liver congestion ,liver function test ,liver perfusion ,prognosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background It has been reported that liver stiffness assessed by transient elastography are correlated with right atrial pressure, which is associated with worse outcome in patients with heart failure (HF). We aimed to clarify clinical implications of hepatic hemodynamic evaluation (liver congestion and hypoperfusion) by abdominal ultrasonography in patients with HF. Methods and Results We performed abdominal ultrasonography, right‐heart catheterization, and echocardiography, then followed up for cardiac events such as cardiac death or worsening HF in patients with HF. Regarding liver congestion, liver stiffness assessed by shear wave elastography (SWE) of the liver was significantly correlated with right atrial pressure determined by right‐heart catheterization (R=0.343; P
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- 2020
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21. Prognostic impacts of changes in left ventricular ejection fraction in heart failure patients with preserved left ventricular ejection fraction
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Tetsuro Yokokawa, Akiomi Yoshihisa, Yu Sato, Yuki Kanno, Mai Takiguchi, Satoshi Abe, Tomofumi Misaka, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, and Yasuchika Takeishi
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundIt has been reported that recovery of left ventricular ejection fraction (LVEF) is associated with better prognosis in heart failure (HF) patients with reduced EF (rEF). However, change of LVEF has not yet been investigated in cases of HF with preserved EF (HFpEF).Methods and resultsConsecutive 1082 HFpEF patients, who had been admitted to hospital due to decompensated HF (EF >50% at the first LVEF assessment at discharge), were enrolled, and LVEF was reassessed within 6 months in the outpatient setting (second LVEF assessment). Among the HFpEF patients, LVEF of 758 patients remained above 50% (pEF group), 138 patients had LVEF of 40%–49% (midrange EF, mrEF group) and 186 patients had LVEF of less than 40% (rEF group). In the multivariable logistic regression analysis, younger age and presence of higher levels of troponin I were predictors of rEF (worsened HFpEF). In the Kaplan-Meier analysis, the cardiac event rate of the groups progressively increased from pEF, mrEF to rEF (log-rank, p
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- 2020
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22. Associations of Benzodiazepine With Adverse Prognosis in Heart Failure Patients With Insomnia
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Yu Sato, Akiomi Yoshihisa, Yu Hotsuki, Koichiro Watanabe, Yusuke Kimishima, Takatoyo Kiko, Yuki Kanno, Tetsuro Yokokawa, Satoshi Abe, Tomofumi Misaka, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Takafumi Ishida, and Yasuchika Takeishi
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benzodiazepine ,heart failure ,prognosis ,Z‐drugs ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The prognostic impact of benzodiazepines has been unclear in patients with heart failure (HF). Methods and Results This was a historical observational cohort study. A total of 826 patients who had been hospitalized for HF and were being treated for insomnia with either benzodiazepines or Z‐drugs (zolpidem, zopiclone, or eszopiclone), were enrolled and divided on the basis of their hypnotics: benzodiazepine group (n=488 [59.1%]) and Z group (n=338 [40.9%]). We compared the patient characteristics and postdischarge prognosis between the groups. The primary end points were rehospitalization for HF and cardiac death. The benzodiazepine group was older (age, 72.0 versus 69.0 years; P=0.010), had a higher prevalence of depression (17.4% versus 8.9%; P
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- 2020
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23. Impaired Frontal Brain Activity in Patients With Heart Failure Assessed by Near‐Infrared Spectroscopy
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Yasuhiro Ichijo, Soichi Kono, Akiomi Yoshihisa, Tomofumi Misaka, Takashi Kaneshiro, Masayoshi Oikawa, Itaru Miura, Hirooki Yabe, and Yasuchika Takeishi
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anxiety ,cognitive function ,dementia ,depression ,heart failure ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The prevalence of depression and/or anxiety disorders is reported to be higher in patients with heart failure (HF) than in the general population, and patients with HF also have coexisting cognitive problems. Recently, the development of near‐infrared spectroscopy (NIRS) has enabled noninvasive measurements of regional cerebral blood volume and brain activity, in terms of cerebral oxyhemoglobin in the cerebral cortex, with a high time resolution. The aim of the current study was to determine the associations between frontal brain activity and depressive symptoms, anxiety status, and cognitive function in patients with HF. Methods and Results We measured and compared frontal brain activity determined by NIRS during a verbal fluency task in patients with HF (n=35) and control subjects (n=28). The Center for Epidemiologic Studies Depression Scale for assessment of depressive symptoms, State‐Trait Anxiety Inventory for assessment of anxiety status, Mini‐Mental State Examination for assessment of cognitive function, and NIRS were simultaneously conducted. NIRS showed that frontal brain activity was significantly lower in the HF group than in the control subjects (28.5 versus 88.0 mM·mm; P
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- 2020
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24. Association between platelet distribution width and prognosis in patients with heart failure.
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Yu Sato, Akiomi Yoshihisa, Koichiro Watanabe, Yu Hotsuki, Yusuke Kimishima, Tetsuro Yokokawa, Tomofumi Misaka, Takamasa Sato, Takashi Kaneshiro, Masayoshi Oikawa, Atsushi Kobayashi, and Yasuchika Takeishi
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Medicine ,Science - Abstract
BackgroundThe prognostic impact of platelet distribution width (PDW), which is a specific marker of platelet activation, has been unclear in patients with heart failure (HF).Methods and resultsWe conducted a prospective observational study enrolling 1,746 hospitalized patients with HF. Patients were divided into tertiles based on levels of PDW: 1st (PDW < 15.9 fL, n = 586), 2nd (PDW 15.9-16.8 fL, n = 617), and 3rd (PDW ≥ 16.9, n = 543) tertiles. We compared baseline patients' characteristics and post-discharge prognosis: all-cause death; cardiac death; and cardiac events. The 3rd tertile showed the highest age and levels of B-type natriuretic peptide compared to other tertiles (1st, 2nd, and 3rd tertiles; age, 69.0, 68.0, and 70.0 years old, P = 0.038; B-type natriuretic peptide, 235.2, 171.9, and 241.0 pg/mL, P < 0.001). Left ventricular ejection fraction was equivalent among the tertiles. In the Kaplan-Meier analysis, rates of all endpoints were the highest in the 3rd tertile (log-rank P < 0.001, respectively). The Cox proportional hazard analysis revealed that the 3rd tertile was associated with adverse prognosis (all-cause death, hazard ratio [HR] 1.716, P < 0.001; cardiac death, HR 1.919, P < 0.001; cardiac event, HR 1.401, P = 0.002).ConclusionsHigh PDW is a novel predictor of adverse prognosis in patients with HF.
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- 2020
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25. Circulating acetoacetate is associated with poor prognosis in heart failure patients
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Tetsuro Yokokawa, Akiomi Yoshihisa, Yuki Kanno, Satoshi Abe, Tomofumi Misaka, Shinya Yamada, Takashi Kaneshiro, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, Kazuhiko Nakazato, Takafumi Ishida, and Yasuchika Takeishi
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Acetoacetate is used as an alternative energy source in the heart, and has the potential to improve cardiac function. However, the prognostic impact of acetoacetate has not been investigated in heart failure. Methods: This study enrolled consecutive 615 hospitalized patients with heart failure. We investigated the associations between circulating acetoacetate and clinical characteristics or prognosis in HF patients. Results: We divided the patients into two groups based on circulating acetoacetate levels (high group: acetoacetate ≥35 µmoL/L, n = 313; and low group: acetoacetate
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- 2019
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26. Better clinical outcome with direct oral anticoagulants in hospitalized heart failure patients with atrial fibrillation
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Akiomi Yoshihisa, Yu Sato, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, and Yasuchika Takeishi
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Heart failure ,Atrial fibrillation ,Anticoagulant therapy ,Direct oral anticoagulants ,Vitamin K antagonists ,Mortality ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Atrial fibrillation (AF) is common in patients with heart failure and is associated with higher mortality. Although previous studies have reported that direct oral anticoagulants (DOACs) reduce the risk of cardiovascular events in out-patients with AF, it remains unclear whether DOACs reduce mortality in hospitalized heart failure (HHF) patients with AF. Therefore, we examined the impact of DOACs on mortality in this group of patients. Methods Consecutive 497 HHF patients with AF were retrospectively registered and divided into three groups on the basis of the presence of anticoagulant therapy: non-anticoagulant group (Non, n = 90), Vit K antagonists (VKAs) group (n = 257) and DOACs group (n = 150). We followed up all the patients for mortality. Results In the Kaplan-Meier analysis (mean follow-up of 1093 days), all-cause mortality was significantly lower in the VKAs and DOACs groups than in the Non group (31.1% and 15.3% vs. 43.3%, log-rank P
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- 2018
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27. Elevated exhaled acetone concentration in stage C heart failure patients with diabetes mellitus
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Tetsuro Yokokawa, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Akiomi Yoshihisa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-ichi Saitoh, Takafumi Ishida, Akito Shimouchi, and Yasuchika Takeishi
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Acetone ,Breath analysis ,Heart failure ,Diabetes mellitus ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Breath acetone is a noninvasive biomarker of heart failure; however, its significance in heart failure patients with diabetes mellitus has yet to be clarified. The objective of this study is to investigate whether exhaled acetone concentration is a noninvasive biomarker in heart failure patients with diabetes mellitus. Methods This study prospectively included 35 diabetic patients with stage C heart failure and 20 diabetic patients with or at risk of heart failure (stage A or B). Exhaled breath was collected after an overnight fast. Results The stage C group had significantly higher brain natriuretic peptide levels, larger left ventricular diameter, lower left ventricular ejection fraction, and more frequent use of β-blocker, compared with the stage A or B group. The stage C group had higher exhaled acetone concentrations than the stage A or B group (p = 0.013). Exhaled acetone concentration was correlated with total ketone bodies (r = 0.588, p
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- 2017
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28. Decreased cardiac mortality with nicorandil in patients with ischemic heart failure
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Akiomi Yoshihisa, Yu Sato, Shunsuke Watanabe, Tetsuro Yokokawa, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Atsushi Kobayashi, and Yasuchika Takeishi
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Ischemic heart failure ,Nicorandil ,Cardiac mortality ,Prognosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Effective treatments in heart failure (HF) patients with ischemic etiology have not been fully established. Nicorandil, combination of nitrate component and sarcolemmal adenosine triphosphate-sensitive potassium channel opener, is a potent vasodilator of coronary and peripheral vessels and has been used as an antianginal agent. Therefore, we examined impacts of nicorandil on cardiac mortality in ischemic HF patients. Methods Consecutive 334 HF patients with ischemic etiology were retrospectively registered and divided into 2 groups based on oral administration of nicorandil: nicorandil group (n = 116) and non-nicorandil group (n = 218). We retrospectively examined cardiac mortality. Results In the Kaplan-Meier analysis (mean follow-up period 963 days), cardiac mortality was significantly lower in the nicorandil group than in the non-nicorandil group (11.2% vs. 19.7%, P = 0.032). In the Cox proportional hazard analysis, usage of nicorandil was a suppressor of cardiac mortality (hazard ratio 0.512, 95% confidence interval 0.275–0.953, P = 0.035), and this result was consistent in several subgroup analyses, such as left ventricular ejection fraction, percutaneous coronary intervention, coronary artery bypass graft, diabetes, β-blockers, and statins. Conclusion Nicorandil is potentially effective for reducing mortality in patients with ischemic heart failure. Trial registration This was a retrospective study.
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- 2017
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29. Shear Wave Dispersion Predicts Liver Fibrosis and Adverse Outcomes in Patients with Heart Failure
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Himika Ohara, Akiomi Yoshihisa, Shinji Ishibashi, Mitsuko Matsuda, Yukio Yamadera, Yukiko Sugawara, Yasuhiro Ichijo, Yu Hotsuki, Koichiro Watanabe, Fumiya Anzai, Yu Sato, Yusuke Kimishima, Tetsuro Yokokawa, Tomofumi Misaka, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, and Yasuchika Takeishi
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viscosity ,fibrosis ,prognosis ,abdominal ultrasonography ,liver function test ,right heart catheterization ,Medicine - Abstract
Background: It has been recently reported that liver stiffness assessed by transient elastography reflects right atrial pressure (RAP) and is associated with worse outcomes in patients with heart failure (HF). However, the relationship between shear wave dispersion (SWD, a novel indicator of liver viscosity) determined by abdominal ultrasonography and RAP, and the prognostic impact of SWD on HF patients have not been fully examined. We aimed to clarify the associations of SWD with parameters of liver function test (LFT) and right heart catheterization (RHC), as well as with cardiac events such as cardiac death and worsening HF, in patients with HF. Methods: We performed abdominal ultrasonography, LFT and RHC in HF patients (n = 195), and followed up for cardiac events. We examined associations between SWD and parameters of LFT and RHC. Results: There were significant correlations between SWD and circulating levels of direct bilirubin (R = 0.222, p = 0.002), alkaline phosphatase (R = 0.219, p = 0.002), cholinesterase (R = −0.184, p = 0.011), and 7S domain of collagen type IV (R = 0.177, p = 0.014), but not with RAP (R = 0.054, p = 0.567) or cardiac index (R = −0.015, p = 0.872). In the Kaplan–Meier analysis, cardiac event rate was significantly higher in the high SWD group (SWD ≥ 10.0 (m/s)/kHz, n = 103) than in the low SWD group (SWD < 10.0 (m/s)/kHz, n = 92; log-rank, p = 0.010). In the Cox proportional hazard analysis, high SWD was associated with high cardiac event rates (hazard ratio, 2.841; 95% confidence interval, 1.234–6.541, p = 0.014). In addition, there were no interactions between SWD and all subgroups, according to the subgroup analysis. Conclusions: SWD assessed by abdominal ultrasonography reflects liver fibrosis rather than liver congestion, and is associated with adverse prognosis in HF patients.
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- 2020
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30. Glasgow-Blatchford Score Predicts Post-Discharge Gastrointestinal Bleeding in Hospitalized Patients with Heart Failure
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Yu Hotsuki, Yu Sato, Akiomi Yoshihisa, Koichiro Watanabe, Yusuke Kimishima, Takatoyo Kiko, Tetsuro Yokokawa, Tomofumi Misaka, Takamasa Sato, Takashi Kaneshiro, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, and Yasuchika Takeishi
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Glasgow-Blatchford Score ,gastrointestinal bleeding ,management ,prognosis ,heart failure ,Medicine - Abstract
Background: The Glasgow-Blatchford Score (GBS) is one of the most widely used scoring systems for predicting clinical outcomes for gastrointestinal bleeding (GIB). However, the clinical significance of the GBS in predicting GIB in patients with heart failure (HF) remains unclear. Methods and Results: We conducted a prospective observational study in which we collected the clinical data of a total of 2236 patients (1130 men, median 70 years old) who were admitted to Fukushima Medical University Hospital for acute decompensated HF. During the post-discharge follow-up period of a median of 1235 days, seventy-eight (3.5%) patients experienced GIB. The GBS was calculated based on blood urea nitrogen, hemoglobin, systolic blood pressure, heart rate, and history of hepatic disease. The survival classification and regression tree analysis revealed that the accurate cut-off point of the GBS in predicting post-discharge GIB was six points. The patients were divided into two groups: the high GBS group (GBS > 6, n = 702, 31.4%) and the low GBS group (GBS ≤ 6, n = 1534, 68.6%). The Kaplan–Meier analysis showed that GIB rates were higher in the high GBS group than in the low GBS group. Multivariate Cox proportional hazards analysis adjusted for age, malignant tumor, and albumin indicated that a high GBS was an independent predictor of GIB (hazards ratio 2.258, 95% confidence interval 1.326–3.845, p = 0.003). Conclusions: A high GBS is an independent predictor and useful risk stratification score of post-discharge GIB in patients with HF.
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- 2020
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31. Clinical Significance of Get With the Guidelines–Heart Failure Risk Score in Patients With Chronic Heart Failure After Hospitalization
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Satoshi Suzuki, Akiomi Yoshihisa, Yu Sato, Yuki Kanno, Shunsuke Watanabe, Satoshi Abe, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Takafumi Ishida, and Yasuchika Takeishi
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GWTG‐HF risk score ,heart failure ,heart failure with preserved ejection fraction ,long‐term follow‐up ,prognosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The Get With the Guidelines–Heart Failure (GWTG‐HF) risk score was developed using American Heart Association GWTG‐HF program data and predicts in‐hospital mortality in patients with acute heart failure (HF). We aimed to clarify the prognostic impacts of the GWTG‐HF risk score in patients with HF after discharge. Methods and Results We examined the GWTG‐HF score in 1452 patients with HF, who were admitted to our hospital and discharged after treatment, by calculating 7 predetermined variables. We divided all subjects into 3 groups according to the GWTG‐HF risk score (low, moderate, and high score groups). The plasma B‐type natriuretic peptide level significantly increased with increasing GWTG‐HF risk score severity (median values of B‐type natriuretic peptide: 167.0 in low, 260.7 in moderate, and 418.2 pg/mL in high score groups). We followed up all subjects after discharge, and there were 347 (23.9%) all‐cause deaths and 407 (28.0%) cardiac events in follow‐up periods. A Kaplan‐Meier survival curve demonstrated that event rates of all‐cause death and cardiovascular events, including worsening HF and cardiac death, significantly increased with increasing GWTG‐HF risk score severity in all subjects, and also in 749 patients with HF with preserved ejection fraction (ejection fraction ≥50%) and 703 patients with HF with reduced ejection fraction (ejection fraction
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- 2018
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32. Associations between diabetes mellitus and pulmonary hypertension in chronic respiratory disease patients.
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Tomoko Takahashi, Akiomi Yoshihisa, Koichi Sugimoto, Tetsuro Yokokawa, Tomofumi Misaka, Takashi Kaneshiro, Masayoshi Oikawa, Atsushi Kobayashi, Kazuhiko Nakazato, Takafumi Ishida, and Yasuchika Takeishi
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Medicine ,Science - Abstract
BACKGROUND:Pulmonary hypertension (PH) is a common complication of chronic respiratory disease. Recent studies have reported diabetes mellitus (DM) to be a poor prognostic factor in patients with chronic respiratory disease, including chronic obstructive pulmonary disease or interstitial pneumoniae. However, the association between DM and PH in chronic respiratory disease remains unclear. In this study, we aimed to investigate whether DM is a predictor of PH in patients with chronic respiratory disease. METHODS:We prospectively analyzed 386 patients in our hospital with chronic respiratory disease. An echocardiographic pressure gradient between the right atrium and the right ventricle of ≥ 40 mmHg was defined as PH. We compared the clinical characteristics and impact of DM between chronic respiratory disease patients with and those without PH. RESULTS:Of the 386 patients, 42 (10.9%) were diagnosed as having PH. The PH group had higher modified medical research council (mMRC) grade and complication rate of DM, but not hypertension and hyperlipidemia, when compared to the non-PH group. Multivariable logistic regression analysis revealed that mMRC scale (odds ratio 1.702, 95% confidence interval, 1.297 to 2.232, P < 0.001) and presence of DM (odd ratio 2.935, 95% confidence interval, 1.505 to 5.725, P = 0.002) were associated with PH in chronic respiratory disease patients. CONCLUSION:DM is potentially associated with PH and is an independent factor for prediction of PH in patients with chronic respiratory disease.
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- 2018
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33. Associations of Acid Suppressive Therapy With Cardiac Mortality in Heart Failure Patients
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Akiomi Yoshihisa, Mai Takiguchi, Yuki Kanno, Akihiko Sato, Tetsuro Yokokawa, Shunsuke Miura, Satoshi Abe, Tomofumi Misaka, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu‐ichi Saitoh, and Yasuchika Takeishi
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acid suppressive therapy ,heart failure ,histamine H2 receptor antagonists ,prognosis ,proton pump inhibitors ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundIt has been recently reported that histamine H2 receptor antagonists (H2RAs) are associated with impairment of ventricular remodeling and incident heart failure. In addition, favorable pleiotropic effects and adverse effects of proton pump inhibitors (PPIs) on cardiovascular disease have also been reported. We examined the associations of acid suppressive therapy using H2RAs or PPIs with cardiac mortality in patients with heart failure. Methods and ResultsIn total, 1191 consecutive heart failure patients were divided into 3 groups: a non–acid suppressive therapy group (n=363), an H2RA group (n=164), and a PPI group (n=664). In the follow‐up period (mean 995 days), 169 cardiac deaths occurred. In the Kaplan–Meier analysis, cardiac mortality was significantly lower in the PPI group than in the H2RA and non–acid suppressive therapy groups (11.0% versus 21.3% and 16.8%, respectively; log‐rank P=0.004). In the multivariable Cox proportional hazards analysis, use of PPIs, but not H2RAs, was found to be an independent predictor of cardiac mortality (PPIs: hazard ratio 0.488, P=0.002; H2RAs: hazard ratio 0.855, P=0.579). The propensity‐matched 1:1 cohort was assessed based on propensity score (H2RAs, n=164; PPIs, n=164). Cardiac mortality was significantly lower in the PPI group than in the H2RA group in the postmatched cohort (log‐rank P=0.025). In the Cox proportional hazards analysis, the use of PPIs was a predictor of cardiac mortality in the postmatched cohort (hazard ratio 0.528, P=0.028). ConclusionsPPIs may be associated with better outcome in patients with heart failure.
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- 2017
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34. Liver dysfunction assessed by model for end-stage liver disease excluding INR (MELD-XI) scoring system predicts adverse prognosis in heart failure.
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Satoshi Abe, Akiomi Yoshihisa, Mai Takiguchi, Takeshi Shimizu, Yuichi Nakamura, Hiroyuki Yamauchi, Shoji Iwaya, Takashi Owada, Makiko Miyata, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Koichi Sugimoto, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-ichi Saitoh, and Yasuchika Takeishi
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Medicine ,Science - Abstract
AIMS: Liver dysfunction due to heart failure (HF) is often referred to as cardiac or congestive hepatopathy. The composite Model for End-Stage Liver Disease excluding INR (MELD-XI) is a robust scoring system of liver function, and a high score is associated with poor prognosis in advanced HF patients with a heart transplantation and/or ventricular assist device. However, the impact of MELD-XI on the prognosis of HF patients in general remains unclear. METHODS AND RESULTS: We retrospectively analyzed 562 patients who were admitted to our hospital for the treatment of decompensated HF. A MELD-XI score was graded, and patients were divided into two groups based on the median value of MELD-XI score: Group L (MELD-XI
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- 2014
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35. Neutrophil Extracellular Traps in Myocardial Tissue Drive Cardiac Dysfunction and Adverse Outcomes in Patients With Heart Failure With Dilated Cardiomyopathy.
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Shohei Ichimura, Tomofumi Misaka, Ryo Ogawara, Yusuke Tomita, Fumiya Anzai, Yu Sato, Shunsuke Miura, Tetsuro Yokokawa, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, Akiomi Yoshihisa, and Yasuchika Takeishi
- Abstract
BACKGROUND: The immune systems and chronic inflammation are implicated in the pathogenesis of dilated cardiomyopathy (DCM) and heart failure. However, the significance of neutrophil extracellular traps (NETs) in heart failure remains to be elucidated. METHODS: We enrolled consecutive 62 patients with heart failure with idiopathic DCM who underwent endomyocardial biopsy. Biopsy specimens were subjected to fluorescent immunostaining to detect NETs, and clinical and outcome data were collected. Ex vivo and in vivo experiments were conducted. RESULTS: The numbers of NETs per myocardial tissue area and the proportion of NETs per neutrophil were significantly higher in patients with DCM compared with non-DCM control subjects without heart failure, and the numbers of NETs were negatively correlated with left ventricular ejection fraction. Patients with DCM with NETs (n=32) showed lower left ventricular ejection fraction and higher BNP (B-type natriuretic peptide) than those without NETs (n=30). In a multivariable Cox proportional hazard model, the presence of NETs was independently associated with an increased risk of adverse cardiac events in patients with DCM. To understand specific underlying mechanisms, extracellular flux analysis in ex vivo revealed that NETs-containing conditioned medium from wild-type neutrophils or purified NET components led to impaired mitochondrial oxygen consumption of cardiomyocytes, while these effects were abolished when PAD4 (peptidyl arginine deiminase 4) in neutrophils was genetically ablated. In a murine model of pressure overload, NETs in myocardial tissue were predominantly detected in the acute phase and persisted throughout the ongoing stress. Four weeks after transverse aortic constriction, left ventricular ejection fraction was reduced in wild-type mice, whereas PAD4-deficient mice displayed preserved left ventricular ejection fraction without inducing NET formation. CONCLUSIONS: NETs in myocardial tissue contribute to cardiac dysfunction and adverse outcomes in patients with heart failure with DCM, potentially through mitochondrial dysfunction of cardiomyocytes. [ABSTRACT FROM AUTHOR]
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- 2024
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36. Features and Outcomes of Histologically Proven Myocarditis With Fulminant Presentation
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Koshiro Kanaoka, Kenji Onoue, Satoshi Terasaki, Tomoya Nakano, Michikazu Nakai, Yoko Sumita, Kinta Hatakeyama, Fumio Terasaki, Rika Kawakami, Yoshitaka Iwanaga, Yoshihiro Miyamoto, Yoshihiko Saito, Satoshi Yuda, Masaya Tanno, Toru Takahashi, Hisashi Yokoshiki, Masahiro Toba, Toshihisa Anzai, Toshiyuki Nagai, Takuma Sato, Takashi Takenaka, Seiji Yamazaki, Yuki Katagiri, Toshiharu Takeuchi, Kazuya Sugitatsu, Shigeo Kakinoki, Tomoaki Matsumoto, Kazushi Urasawa, Michinao Tan, Ichizo Tsujino, Mitsunori Kamigaki, Hirofumi Tomita, Kenji Hanada, Motoi Kushibiki, Akihiro Nakamura, Yoshihiro Morino, Takahito Nasu, Satoshi Yasuda, Hideaki Suzuki, Kaoru Iwabuchi, Kanako Tsuji, Shigeto Namiuchi, Tatsuya Komaru, Masahiro Yagi, Shoko Uematsu, Toshiaki Takahashi, Satoru Takeda, Toru Nakanishi, Masafumi Watanabe, Masahiro Wanezaki, Motoyuki Matsui, Shigeo Sugawara, Yasuchika Takeishi, Masayoshi Oikawa, Nobuo Komatsu, Satoshi Suzuki, Hiroshi Okamoto, Noriyuki Takeyasu, Daiki Akiyama, Yutaka Eki, Tsunekazu Kakuta, Tomoyo Sugiyama, Tomomi Koizumi, Koji Ueno, Kazuomi Kario, Mizuri Taki, Yuri Matsumoto, Takanori Yasu, Osamu Nishioka, Shigeto Naito, Makoto Murata, Shoichi Tange, Katsumi Kaneko, Makoto Muto, Hiroshi Inagaki, Shuichi Hasegawa, Eizo Tachibana, Wataru Atsumi, Masahiro Suzuki, Toshihiro Muramatsu, Yoshihiro Yamada, Isao Taguchi, Yoshiaki Fukuda, Akihiro Matsui, Junji Kanda, Koji Hozawa, Akihiko Matsumura, Wataru Shimizu, Takeshi Yamamoto, Issei Komuro, Masaru Hatano, Takanori Ikeda, Shunsuke Kiuchi, Taishiro Chikamori, Yasuyoshi Takei, Kyoko Soejima, Toshinori Minamishima, Hiroyuki Tanaka, Shigeo Shimizu, Masashi Kasao, Tadayuki Kadohira, Tohru Minamino, Kazunori Shimada, Hiroshi Iwata, Yukihiko Momiyama, Takashi Ashikaga, Toshihiro Nozato, Yasumasa Fujiwara, Kenji Inoue, Tetsuo Sasano, Junji Matsuda, Yasuhiro Ishii, Yuichi Ono, Kengo Tanabe, Yu Horiuchi, Toshiro Shinke, Yusuke Kodama, Masao Moroi, Yoshiyuki Yazaki, Taisuke Mizumura, Hiroshi Ohta, Yoshihiro Akashi, Nozomi Kotoku, Yuji Ikari, Mitsunori Maruyama, Yasuhiro Sato, Koichi Tamura, Masaaki Konishi, Hiroshi Suzuki, Mio Ebato, Kazuki Fukui, Kazuhiko Yumoto, Takamasa Iwasawa, Takeshi Kashimura, Kazuyoshi Takahashi, Yoshinobu Okada, Bunji Kaku, Kazuo Usuda, Michiro Maruyama, Tomoki Kameyama, Toshinori Higashikata, Akihiko Hodatsu, Kazuo Osato, Yoji Nagata, Koji Maeno, Kazuo Satake, Takao Sawanobori, Noboru Watanabe, Koichiro Kuwahara, Hirohiko Motoki, Hiroshi Kitabayashi, Kyuhachi Otagiri, Tsunesuke Kono, Daisuke Yamagishi, Yoshikazu Yazaki, Toshiyuki Noda, Itsuro Morishima, Naoki Watanabe, Shinichiro Tanaka, Tomoya Onodera, Ryuzo Nawada, Akinori Watanabe, Masaki Matsunaga, Satoru Suwa, Hiroshi Sakamoto, Hiroki Sakamoto, Takeshi Aoyama, Norio Kanamori, Masahiro Muto, Yuichiro Maekawa, Hayato Ohtani, Yukio Ozaki, Kenshin Naruse, Kenji Takemoto, Haruo Kamiya, Takeshi Suzuki, Yasushi Tomita, Susumu Suzuki, Ryosuke Kametani, Hidekazu Aoyama, Hiroyuki Osanai, Ken Harada, Kenji Kada, Tomoaki Saeki, Koichi Kobayashi, Yasuhiro Ogawa, Akihiro Terasawa, Masanori Shinoda, Mitsutoshi Oguri, Kiyokazu Shimizu, Akinori Sawamura, Atsushi Sugiura, Kosuke Hattori, Shinji Mokuno, Kazuhisa Kondo, Kaoru Dohi, Keishi Moriwaki, Atsunobu Kasai, Tetsuya Nakakuki, Kazuaki Kaitani, Toshikazu Jinnai, Takashi Yamamoto, Hiroyuki Kurata, Atsuyuki Wada, Masaharu Akao, Yasuhiro Hamatani, Kazuya Ishibashi, Yoshiki Akakabe, Yasuhide Asaumi, Hideo Matama, Yasushi Sakata, Hidetaka Kioka, Hiroshi Takaishi, Toru Takase, Mitsuo Matsuda, Fumi Sato, Shinji Hasegawa, Kenichi Ishigami, Minoru Ichikawa, Takashi Takagi, Moriaki Inoko, Masaaki Hoshiga, Shuichi Fujita, Yoshihiro Takeda, Takahiko Kawarabayashi, Hideyuki Takaoka, Kenji Nakajima, Tadashi Yuguchi, Tatsuya Kawasaki, Yukinori Shinoda, Yukihito Sato, Masaharu Ishihara, Yuki Matsumoto, Hiroya Kawai, Tomofumi Takaya, Kouki Matsuo, Toshiaki Mano, Kenichi Hirata, Eriko Hisamatsu, Nobutaka Inoue, Koichi Tamita, Naoki Mukohara, Hisashi Shimoyama, Toru Miyajima, Toshihiro Tamura, Yodo Tamaki, Megumi Suzuki, Ryoji Yokota, Manabu Horii, Kazuo Yamanaka, Hiroyuki Kawata, Yukihiro Hashimoto, Yasuki Nakada, Hitoshi Nakagawa, Tomoya Ueda, Taku Nishida, Ayako Seno, Makoto Watanabe, Takashi Akasaka, Takashi Tanimoto, Mamoru Toyofuku, Kazuhiro Yamamoto, Yoshiharu Kinugasa, Masayuki Hirai, Hiroshi Nasu, Kinya Shirota, Tsuyoshi Oda, Takefumi Oka, Kazushige Kadota, Masanobu Ohya, Hiroshi Ito, Kazufumi Nakamura, Soichiro Ogura, Soichiro Fuke, Shiro Uemura, Hiromi Matsubara, Atsuyuki Watanabe, Nobuyuki Morishima, Yasuki Kihara, Takayuki Hidaka, Hironori Ueda, Yujiro Ono, Yuji Muraoka, Miyo Hatanari, Yoshinori Miyamoto, Keigo Dote, Masaya Kato, Masafumi Yano, Mamoru Mochizuki, Yasuhiro Ikeda, Hiroyuki Fujinaga, Shinobu Hosokawa, Masataka Sata, Koji Yamaguchi, Naoko Aki, Tetsuo Minamino, Yuichi Miyake, Yuichiro Takagi, Masayuki Doi, Yoshio Taketani, Hideki Okayama, Tatsuya Shigematsu, Akinori Higaki, Osamu Yamaguchi, Shinji Inaba, Shuntaro Ikeda, Kazuya Kawai, Hiroaki Kitaoka, Toru Kubo, Kenji Ando, Kaoru Inui, Yoshihiro Fukumoto, Kensuke Hori, Takehiro Homma, Tomohiro Kawasaki, Masahiro Mohri, Masaki Fujiwara, Hiroyuki Tsutsui, Tomomi Ide, Shin-Ichiro Miura, Takashi Kuwano, Hideki Shimomura, Toshiaki Kadokami, Masanao Taba, Katsuhiro Kondou, Toru Kubota, Daisuke Nagatomo, Yasushi Mukai, Ryuichi Matsukawa, Hideki Tashiro, Mitsuhiro Shimomura, Koji Maemura, Hiroaki Kawano, Koji Oku, Toshihiko Yamasa, Yoshihisa Kizaki, Tomohiro Sakamoto, Yudai Tamura, Teruhiko Ito, Kazuteru Fujimoto, Kenichi Tsujita, Seiji Takashio, Hirofumi Kurokawa, Naohiko Takahashi, Shotaro Saito, Masaya Arikawa, Yoshisato Shibata, Kensaku Nishihira, Toshihiro Tsuruda, Masahiro Sonoda, Nobuhiko Atsuchi, Mitsuru Ohishi, Koji Higuchi, Masaaki Miyata, Naoya Oketani, Yoshinori Akimoto, Tomohiro Asahi, and Minoru Wake
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Male ,Myocarditis ,Physiology (medical) ,Humans ,Heart Transplantation ,Female ,Arrhythmias, Cardiac ,Middle Aged ,Prognosis ,Cardiology and Cardiovascular Medicine ,Retrospective Studies - Abstract
Background: Fulminant myocarditis presentation (FMP) is a rare and severe presentation of myocarditis. The natural history of FMP and its clinical features associated with poor outcomes are incompletely understood because there is a lack of generalizable evidence. Methods: This multicenter retrospective cohort study included patients hospitalized with histologically proven myocarditis who underwent catecholamine or mechanical support from 235 cardiovascular training hospitals across Japan between April 2012 and March 2017. Clinical features and the prognostic predictors of death or heart transplantation within 90 days on the basis of clinical and pathologic findings were determined using the Kaplan-Meier method, log-rank test, and Cox regression analysis. Results: This study included 344 patients with histologically proven FMP (median age, 54 years; 40% female). The median follow-up was 600 days (interquartile range, 36 to 1599 days) and the cumulative risk of death or heart transplantation at 90 days was 29% (n=98). Results from multivariable Cox regression analysis showed that older age, nonsinus rhythm, low left ventricular wall motion ( Conclusions: The results from analyses of data from this multicenter registry demonstrated that patients with FMP are at a higher risk of death or heart transplantation in real-world settings. These observations inform which clinical and pathologic findings may be useful for prognostication in FMP. Registration: URL: https://www.umin.ac.jp/ctr ; Unique identifier: UMIN000039763.
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- 2022
37. A retrospective investigation to establish new screening approach for the detection of patients at high risk of Fabry disease in male left ventricular hypertrophy patients
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Toru, Kubo, Masashi, Amano, Seiji, Takashio, Takahiro, Okumura, Saori, Yamamoto, Takeru, Nabeta, Masayoshi, Oikawa, Satoshi, Kurisu, Yuri, Ochi, Kenta, Sugiura, Yuichi, Baba, Hajime, Kuroiwa, Takayoshi, Hirota, Naohito, Yamasaki, Shunsuke, Ishii, Kotaro, Nochioka, Yasuchika, Takeishi, Satoshi, Yasuda, Kenichi, Tsujita, Chisato, Izumi, and Hiroaki, Kitaoka
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Male ,Echocardiography ,alpha-Galactosidase ,Fabry Disease ,Humans ,Hypertrophy, Left Ventricular ,Cardiology and Cardiovascular Medicine ,Retrospective Studies - Abstract
The prevalence of Fabry disease (FD) in male patients with left ventricular hypertrophy (LVH) is about 1%. From the perspective of performing more efficient screening with measurement of α-galactosidase (α-Gal) activity, it is important to raise the pretest probability.We retrospectively investigated the prevalence of FD in 701 male patients with LVH who already had been screened by measurement of α-Gal activity in eight hospitals. From the viewpoint of enzymatic screening, we validated previously reported clinical features of FD including the electrocardiographic and echocardiographic characteristics with comparing each clinical determinant between patients with FD and non-FD patients. We finally aimed to establish a new screening approach for the detection of patients at high risk of FD.There were five FD patients (0.7%) in the 701 male patients with LVH. Those five patients with FD all had the cardiac variant type and age at detection of LVH was ≥35 years in all patients. In LVH patients with LV ejection fraction (EF) ≥ 50%, Pend-Q interval 40 msec, SV1 + RV5 4.0 mV, and diffuse LVH were important determinants of FD. In LVH patients with LVEF 50%, asymmetric septal hypertrophy and posterior wall motion abnormality seemed to be associated with FD.In our retrospective study, the prevalence of FD in male patients with LVH was found to be 0.7%. We established the efficient combinations of clinical determinants using age at detection of LVH, Pend-Q interval, high voltage, and LVH pattern in an echocardiogram.
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- 2022
38. Validation of Japanese Bleeding Risk Criteria in Patients After Percutaneous Coronary Intervention and Comparison With Contemporary Bleeding Risk Criteria
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Takeshi, Shimizu, Yuya, Sakuma, Yuta, Kurosawa, Yuuki, Muto, Akihiko, Sato, Satoshi, Abe, Tomofumi, Misaka, Masayoshi, Oikawa, Akiomi, Yoshihisa, Takayoshi, Yamaki, Kazuhiko, Nakazato, Takafumi, Ishida, and Yasuchika, Takeishi
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General Medicine - Published
- 2022
39. Decreases in hepatokine Fetuin-A levels are associated with hepatic hypoperfusion and predict cardiac outcomes in patients with heart failure
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Yusuke Tomita, Tomofumi Misaka, Akiomi Yoshihisa, Yasuhiro Ichijo, Shinji Ishibashi, Mitsuko Matsuda, Yukio Yamadera, Himika Ohara, Yukiko Sugawara, Yu Hotsuki, Koichiro Watanabe, Fumiya Anzai, Yu Sato, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, and Yasuchika Takeishi
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Heart Failure ,Liver ,alpha-2-HS-Glycoprotein ,Elasticity Imaging Techniques ,Humans ,General Medicine ,Cardiology and Cardiovascular Medicine ,Biomarkers - Abstract
Interactions of the heart and the liver remain to be fully understood in the pathophysiology of heart failure (HF). Hepatokines are proteins synthesized and secreted from the liver and regulate systemic metabolisms of peripheral tissues. This study sought to clarify the clinical relevance of hepatokine Fetuin-A in patients with HF.We enrolled 217 participants including 187 hospitalized patients with HF and 30 control subjects who were sought with a comparable age- and sex profile and who had never had HF or structural cardiac abnormalities. First, we examined the levels of Fetuin-A and found that its levels were significantly lower in patients with HF than in the controls. Next, HF patients were categorized into four groups based on hepatic hemodynamics assessed by abdominal ultrasonography which determines liver hypoperfusion by peak systolic velocity (PSV) of the celiac artery and liver stiffness by shear wave elastography (SWE). Fetuin-A levels were significantly decreased in HF patients with liver hypoperfusion compared to those without, but were not different between HF patients with and without elevated liver stiffness. Correlation analysis revealed that circulating Fetuin-A was positively correlated with PSV of the celiac artery but not with SWE of the liver. Kaplan-Meier analysis demonstrated that HF patients with lower Fetuin-A levels were significantly associated with increased adverse outcomes including cardiac deaths and decompensated HF.Liver-derived hepatokine Fetuin-A may be a novel target involved in the cardio-hepatic interactions, as well as a useful biomarker for predicting the prognosis in patients with HF.
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- 2022
40. Prognostic significance of spleen shear wave elastography and dispersion in patients with heart failure: the crucial role of cardio-splenic axis
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Tomofumi Misaka, Akiomi Yoshihisa, Yasuhiro Ichijo, Shinji Ishibashi, Mitsuko Matsuda, Yukio Yamadera, Himika Ohara, Yukiko Sugawara, Fumiya Anzai, Yu Sato, Satoshi Abe, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, and Yasuchika Takeishi
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General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
41. A case of COVID-19-associated fulminant myocarditis due to SARS-CoV-2 Omicron BA.2 sub-lineage in an unvaccinated female
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Shohei Ichimura, Masayoshi Oikawa, Ayano Ikeda, Keiichiro Endo, Yuuki Muto, Joh Akama, Takayoshi Yamaki, Kazuhiko Nakazato, Masahiko Sato, Takafumi Ishida, Osamu Suzuki, and Yasuchika Takeishi
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Cardiology and Cardiovascular Medicine - Published
- 2023
42. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: its history and development, and regional medical cooperation in Fukushima.
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Kazuhiko Nakazato, Koichi Sugimoto, Masayoshi Oikawa, and Yasuchika Takeishi
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PULMONARY hypertension ,ENDARTERECTOMY ,PULMONARY artery ,PUBLIC health - Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is designated as an intractable disease by the Ministry of Health, Labour and Welfare of Japan, and has an extremely poor prognosis if untreated. Surgical pulmonary endarterectomy is the curative treatment for cases in which the organized thrombi are located in the central part of the pulmonary artery, but there had been no effective treatment for cases in which the thrombi are located in the peripheral part of the pulmonary artery. Recently, balloon pulmonary angioplasty (BPA), a transcatheter procedure to dilate stenotic or occluded lesions in the peripheral pulmonary artery, has been rapidly developed. Although BPA was once a globally abandoned procedure due to hemorrhagic complications, Japanese experts have improved the technique, and its safety and efficacy have been enhanced. As a result, BPA is now being reevaluated worldwide. This review describes the history and development of BPA in the treatment of CTEPH, as well as the status of this treatment in Fukushima Prefecture. [ABSTRACT FROM AUTHOR]
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- 2023
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43. Successful management of unstable angina in a ravulizumab-treated patient with paroxysmal nocturnal hemoglobinuria
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Hiroshi Takahashi, Hirotaka Mori, Masahiko Fukatsu, Takahiro Sano, Kayo Harada, Masayoshi Oikawa, Yasuchika Takeishi, Satoshi Kimura, Hiroshi Ohkawara, Tsutomu Shichishima, and Takayuki Ikezoe
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unstable angina ,paroxysmal nocturnal hemoglobinuria ,breakthrough hemolysis ,eculizumab ,General Medicine ,ravulizumab - Abstract
Ravulizumab is an anti-C5 antibody approved for treating paroxysmal nocturnal hemoglobinuria (PNH). In August 2019, a 77-year-old Japanese man with PNH, who had been on ravulizumab treatment for 2 years, was hospitalized for chest discomfort and malaise. Electrocardiography identified a right bundle block, and elevated serum troponin I and d-dimer suggested ischemic heart disease. Cardiac catheterization revealed severe stenosis in the left anterior descending coronary artery, and intracoronary stenting relieved his chest discomfort. The final diagnosis was unstable angina unrelated to ravulizumab, and the patient's ravulizumab treatment was uninterrupted with no significant complications of PNH. This case report highlights the importance of continuing complement inhibition therapy during acute coronary events.
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- 2022
44. Prognostic Effects of Changes in Right Ventricular Fractional Area Change in Patients With Heart Failure
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Yukiko Sugawara, Akiomi Yoshihisa, Ryohei Takeishi, Himika Ohara, Fumiya Anzai, Yu Hotsuki, Koichiro Watanabe, Yu Sato, Satoshi Abe, Tomofumi Misaka, Takamasa Sato, Masayoshi Oikawa, Atsushi Kobayashi, Kazuhiko Nakazato, and Yasuchika Takeishi
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Heart Failure ,Ventricular Dysfunction, Right ,Ventricular Function, Right ,Humans ,Aftercare ,Stroke Volume ,General Medicine ,Cardiology and Cardiovascular Medicine ,Prognosis ,Patient Discharge - Abstract
It is still unclear whether changes in right ventricular function are associated with prognosis in heart failure (HF) patients. This study aimed to examine the prognostic effect of changes in right ventricular fractional area change (RVFAC).Methods and Results: This study enrolled 480 hospitalized patients with decompensated HF, and measured RVFAC with echocardiography at discharge (first examination) and post-discharge in the outpatient setting (second examination). RVFAC was divided into 3 categories:35% in 314 patients, 25-35% in 108 patients, and25% in 58 patients. Next, based on changes in RVFAC from the first to the second examination, the patients were further classed into 4 groups: (1) Preserved/Unchanged (preserved and unchanged RVFAC, n=235); (2) Reduced/Improved (improved RVFAC in at least 1 category, n=106); (3) Reduced/Unchanged (reduced and unchanged RVFAC, n=47); and (4) Preserved or Reduced/Worsened (deteriorated RVAFC in at least 1 category, n=92). Multivariate logistic regression analysis revealed that chronic kidney disease and anemia were the predictors of the preserved or reduced/worsened RVFAC. In the Kaplan-Meier analysis, changes in RVFAC were associated with the cardiac event rate and all-cause mortality. In the multivariable Cox proportional hazard analysis, the preserved or reduced/worsened RVFAC was an independent predictor of cardiac events and all-cause mortality.Changes in RVFAC were associated with post-discharge prognosis in hospitalized heart failure patients.
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- 2022
45. Liver Congestion Assessed by Hepatic Vein Waveforms in Patients With Heart Failure
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Tomofumi Misaka, Tetsuro Yokokawa, Yu Sato, Takashi Kaneshiro, Masayoshi Oikawa, Yasuchika Takeishi, Akiomi Yoshihisa, Yu Hotsuki, Yasuhiro Ichijo, Atsushi Kobayashi, Yusuke Kimishima, Shinya Yamada, Shinji Ishibashi, Mitsuko Matsuda, Fumiya Anzai, Takamasa Sato, Koichiro Watanabe, Yukiko Sugawara, Himika Ohara, and Yukio Yamadera
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.drug_class ,Hazard ratio ,Central venous pressure ,Chronic liver disease ,medicine.disease ,Confidence interval ,medicine.anatomical_structure ,Abdominal ultrasonography ,Internal medicine ,Heart failure ,medicine ,Natriuretic peptide ,Cardiology ,Original Article ,Cardiology and Cardiovascular Medicine ,business ,Vein - Abstract
It has been reported that the pattern of hepatic vein (HV) waveforms determined by abdominal ultrasonography is useful for the diagnosis of hepatic fibrosis in patients with chronic liver disease. We aim to clarify the clinical implications of HV waveform patterns in patients with heart failure (HF).We measured HV waveforms in 350 HF patients, who were then classified into 3 categories based on their waveforms: those with a continuous pattern (C group); those whose V wave ran under the baseline (U group), and those with a reversed V wave (R group). We performed right-heart catheterization, and examined the rate of postdischarge cardiac events, such as cardiac death and rehospitalization due to worsening HF.The number of patients in each of the 3 HV waveform groups was as follows: C group, n = 158; U group, n = 152, and R group, n = 40. The levels of B-type natriuretic peptide (R vs C and U; 245.8 vs 111.7 and 216.6 pg/mL;Among HF patients, those with reversed V waves had higher right atrial pressure and were at higher risk of adverse prognosis.Nous avons appris que le tracé ondulatoire de la veine hépatique (VH) à l’échographie abdominale est utile au diagnostic de la fibrose hépatique chez les patients atteints d’une maladie chronique du foie. Nous avons pour objectif de clarifier les implications cliniques des tracés ondulatoires de la VH chez les patients atteints d’insuffisance cardiaque (IC).Nous avons mesuré les ondulations de la VH de 350 patients atteints d’IC et les avons ensuite classifiés en trois catégories selon leurs ondulations : ceux qui avaient un tracé continu (groupe C); ceux dont l’onde V se présentait selon les valeurs de référence (groupe U); ceux qui avaient une onde V inversée (groupe R). Nous avons réalisé un cathétérisme cardiaque droit et examiné le taux d’événements cardiaques après la sortie de l’hôpital tels que la mort d’origine cardiaque et la réhospitalisation en raison de l’aggravation de l’IC.Le nombre de patients dans chacun des trois groupes d’ondulations de la VH était réparti comme suit : groupe C, n = 158; groupe U, n = 152 et groupe R, n = 40. Les concentrations en peptides natriurétiques de type B (RChez les patients atteints d’IC, ceux qui avaient des ondes V inversées avaient une pression plus élevée de l’oreillette droite et étaient exposés à un risque plus élevé de pronostic défavorable.
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- 2021
46. Cancer therapeutics-related cardiovascular dysfunction: Basic mechanisms and clinical manifestation
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Masayoshi Oikawa, Takafumi Ishida, and Yasuchika Takeishi
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Cardiology and Cardiovascular Medicine - Abstract
Although recent advances in cancer treatment improve cancer prognosis, cancer therapeutics-related cardiovascular dysfunction (CTRCD) significantly contributes to the global burden of cardiovascular disease. CTRCD causes two crucial issues: first, premature treatment interruption or discontinuation of chemotherapy; second, the development of congestive heart failure during and after cancer treatment. Thus, early detection and prompt treatment of CTRCD may improve the prognosis in cancer patients. This review covers representative anticancer drugs, including anthracyclines, human epidermal growth factor 2 inhibitors, tyrosine kinase inhibitors, proteasome inhibitors, and immune checkpoint inhibitors. We focus on the molecular mechanisms of CTRCD and various approaches to diagnosis, prevention, monitoring, and treatment.
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- 2022
47. Anti-mitochondrial Antibodies in Patients with Dilated Cardiomyopathy
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Masayoshi Oikawa, Tetsuro Yokokawa, Takashi Kaneshiro, Takamasa Sato, Akiomi Yoshihisa, Yasuchika Takeishi, Atsushi Kobayashi, Tomofumi Misaka, Takayoshi Yamaki, and Hiroyuki Kunii
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Cardiomyopathy, Dilated ,Male ,medicine.medical_specialty ,medicine.drug_class ,Aspartate transaminase ,030204 cardiovascular system & hematology ,Gastroenterology ,Ventricular Function, Left ,Thyroiditis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Natriuretic Peptide, Brain ,parasitic diseases ,Internal Medicine ,Natriuretic peptide ,Humans ,Medicine ,Myopathy ,Aged ,Ejection fraction ,biology ,anti-mitochondrial antibodies ,primary biliary cholangitis ,Liver Cirrhosis, Biliary ,business.industry ,Stroke Volume ,Dilated cardiomyopathy ,General Medicine ,medicine.disease ,dilated cardiomyopathy ,Respiratory failure ,biology.protein ,Original Article ,030211 gastroenterology & hepatology ,Antibody ,medicine.symptom ,business - Abstract
Objective It has been reported that anti-mitochondrial antibodies (AMAs) recognize mitochondrial antigens and are associated with some diseases involving multiple organs, such as primary biliary cholangitis, Sjögren syndrome, Hashimoto's thyroiditis, systemic sclerosis, interstitial pneumoniae, dilated cardiomyopathy, and tubulointerstitial nephritis. In the current study, we examined the prevalence of AMAs in patients with dilated cardiomyopathy (DCM) and their clinical characteristics. Methods We enrolled 270 patients with DCM. We measured serum AMAs and analyzed the associated factors. Out of the 270 patients, positive AMAs were detected in 3 patients (1.1%; mean age, 68 years old; 2 men). These three patients had a significantly higher prevalence of primary biliary cholangitis and myopathy and levels of alanine alkaline phosphatase than those who were negative for said antibodies. There were no significant differences in the levels of B-type natriuretic peptide, aspartate transaminase, and left ventricular ejection fraction between these groups of patients. During the follow-up period, two of the three patients died due to respiratory failure. The other patient survived but experienced type II respiratory failure. Conclusion The prevalence of AMAs in 270 DCM patients was only 1.1%, and these patients suffered from respiratory failure.
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- 2021
48. Intrarenal Doppler ultrasonography reflects hemodynamics and predicts prognosis in patients with heart failure
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Tetsuro Yokokawa, Atsushi Kobayashi, Yu Sato, Yasuhiro Ichijo, Yasuchika Takeishi, Koichiro Watanabe, Akiomi Yoshihisa, Masayoshi Oikawa, Mitsuko Matsuda, Shinji Ishibashi, Yukio Yamadera, and Tomofumi Misaka
- Subjects
Male ,medicine.medical_specialty ,Cardiac output ,Science ,Cardiac index ,Cardiology ,Hemodynamics ,Diseases ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Kidney ,Article ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Medical research ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Heart Failure ,Multidisciplinary ,business.industry ,Central venous pressure ,Health care ,Ultrasonography, Doppler ,Middle Aged ,medicine.disease ,Prognosis ,Heart failure ,Heart Function Tests ,symbols ,Medicine ,Female ,Ultrasonography ,business ,Doppler effect ,Perfusion ,Biomarkers ,Blood Flow Velocity - Abstract
We aimed to clarify clinical implications of intrarenal hemodynamics assessed by intrarenal Doppler ultrasonography (IRD) and their prognostic impacts in heart failure (HF). We performed a prospective observational study, and examined IRD and measured interlobar renal artery velocity time integral (VTI) and intrarenal venous flow (IRVF) patterns (monophasic or non-monophasic pattern) to assess intrarenal hypoperfusion and congestion in HF patients (n = 341). Seven patients were excluded in VTI analysis due to unclear imaging. The patients were divided into groups based on (A) VTI: high VTI (VTI ≥ 14.0 cm, n = 231) or low VTI (VTI
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- 2020
49. ATTR Amyloidosis Concomitant with Parkinsonism and Cardiac Sympathetic Neuropathy
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Fumika Haga, Masayoshi Oikawa, Joh Akama, Takatoyo Kiko, Shinya Yamada, Akiomi Yoshihisa, Kazuhiko Nakazato, and Yasuchika Takeishi
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Cultural Studies ,History ,Images in Nuclear Cardiology ,Literature and Literary Theory - Published
- 2022
50. Clinical impact of sleep-disordered breathing on very short-term blood pressure variability determined by pulse transit time
- Author
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Takashi Kaneshiro, Kento Wada, Takayoshi Yamaki, Yuko Niimura, Akiomi Yoshihisa, Yusuke Kimishima, Tomofumi Misaka, Satoshi Abe, Tetsuro Yokokawa, Yasuchika Takeishi, Atsushi Kobayashi, Hiroyuki Kunii, and Masayoshi Oikawa
- Subjects
medicine.medical_specialty ,Physiology ,Diastole ,Blood Pressure ,Pulse Wave Analysis ,030204 cardiovascular system & hematology ,Left ventricular hypertrophy ,Logistic regression ,03 medical and health sciences ,Sleep Apnea Syndromes ,0302 clinical medicine ,Internal medicine ,Internal Medicine ,medicine ,Humans ,030212 general & internal medicine ,Subclinical infection ,business.industry ,Pulse Transit Time ,medicine.disease ,nervous system diseases ,respiratory tract diseases ,Blood pressure ,Breathing ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Kidney disease - Abstract
Background Sleep-disordered breathing (SDB) and blood pressure variability (BPV) are strongly associated with cardiovascular diseases. Recently, pulse transit time (PTT) has enabled the monitoring of beat-to-beat BP; however, little is known about its clinical utility. The present study aimed to clarify the impact of SDB on very short-term BPV determined by PTT-based BP monitoring (PTT-BP). Methods We analyzed 242 patients with suspected SDB. PTT-BP was continuously recorded overnight together with a portable sleep monitor. PTT index was defined as the average number of transient rises in PTT-BP (≥12 mmHg) within 30 s/h. We compared PTT-BP values with each SDB parameter, and examined the association between BPV and subclinical organ damage. Results Standard deviation (SD) of systolic, mean or diastolic PTT-BP, which indicates very short-term BPV, was significantly correlated with apnea--hypopnea index (AHI) and oxygen desaturation index (ODI). PTT index was positively associated with AHI, ODI, and minimal SpO2. Regression analyses showed that AHI and ODI were significant variables to determine systolic, mean, or diastolic PTT-BP SD and PTT index. Logistic regression analyses demonstrated that diastolic PTT-BP SD significantly influenced the presence of chronic kidney disease and left ventricular hypertrophy. Conclusion SDB severity was closely associated with very short-term BP variability, and diastolic PTT-BP SD might be an important factor linked to subclinical organ damage. PTT-BP measurement may be useful to evaluate very short-term BPV during the night.
- Published
- 2020
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