Publications by authors named "Makoto Watanabe"

578 Publications

A collaboration between physicians and journalists to create unbiased health information.

BMJ 2022 05 13;377:o1209. Epub 2022 May 13.

Medical Governance Research Institute, Tokyo, Japan.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmj.o1209DOI Listing
May 2022

Seasonal variations in the amount of black carbon particles deposited on the leaf surfaces of nine Japanese urban greening tree species and their related factors.

Int J Phytoremediation 2022 May 13:1-11. Epub 2022 May 13.

Institute of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan.

As black carbon (BC) particles can be deposited on the leaf surfaces, urban greening is considered to be effective in purifying urban air. However, little information on the seasonal variations in the amount of BC particles deposited on the leaf surfaces (BC amount on the leaves) is available in Japanese urban greening tree species. Therefore, we investigated seasonal variations in the BC amount on the leaves of evergreen (, , and ) and deciduous (, , , and ) broad-leaved tree species. The BC amount on the leaves tended to increase from April for different periods, and then reached a saturated state in the tree species, excluding . In the 4 evergreen broad-leaved trees, the seasonal variation was positively correlated with the atmospheric concentration of BC particle. In the 5 deciduous broad-leaved trees, the seasonal variation was negatively and positively correlated with the water-repellence (water droplet contact angle) and the amount of epicuticular wax on the leaf surface, respectively. Therefore, the BC amounts on the leaves of evergreen and deciduous broad-leaved urban tree species are considered to be mainly regulated by environmental factors and leaf surface characteristics, respectively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/15226514.2022.2072808DOI Listing
May 2022

Incidence and prognostic impact of the calcified nodule in coronary artery disease patients with end-stage renal disease on dialysis.

Heart Vessels 2022 Apr 30. Epub 2022 Apr 30.

Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Japan.

Coronary artery calcification is frequently observed in coronary artery disease (CAD) patients with end-stage renal disease (ESRD). Calcified nodule (CN) is recognized as one of the vulnerable plaque characteristics responsible for acute coronary syndrome (ACS). Although CN is a cause of ACS in only 10%, its prevalence may be higher in elderly patients and/or ESRD. The aim of this study is to investigate incidence, clinical characteristics, and prognostic impact of CN in CAD patients with ESRD on dialysis. A total of 51 vessels from 49 CAD patients with ESRD on dialysis were enrolled in this study. CN was defined as a high-backscattering mass protruding into the lumen with a strong signal attenuation and an irregular surface by optical coherence tomography. Incidence, clinical characteristics and prognosis of patients with CN were studied. Major adverse cardiac events (MACE) were defined as a composite of all-cause death, non-fatal myocardial infarction, target vessel revascularization (TVR) and stroke. CNs were observed in 30 vessels from 29 patients (59.2%). Duration of dialysis was significantly longer in CN group than in non-CN group (P = 0.03). Overall, all-cause death, cardiac death, TVR and MACE occurred in 7 (14.3%), 3 (6.1%), 11 (22.4%) and 16 (32.7%) patients during follow-up (median 826 days), respectively. Kaplan-Meier survival analysis revealed that MACE-free survival was significantly lower in patients with CN compared with those without CN (Log-rank, P = 0.036).In conclusion, CN was observed in about 60% of the CAD patients with ESRD and was associated with duration of dialysis and worse prognosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00380-022-02076-1DOI Listing
April 2022

Prevention of Contrast-Induced Nephropathy After Cardiovascular Catheterization and Intervention With High-Dose Strong Statin Therapy in Japan - The PREVENT CINC-J Study.

Circ J 2022 Apr 22. Epub 2022 Apr 22.

Department of Cardiovascular Medicine, Nara Medical University.

Background: Previous studies have reported that high-dose strong statin therapy reduces the incidence of contrast-induced nephropathy (CIN) in statin naïve patients; however, the efficacy of high-dose strong statins for preventing CIN in real-world clinical practice remains unclear. The aim of this study was to evaluate the efficacy of strong statin therapy in addition to fluid hydration for preventing CIN after cardiovascular catheterization.Methods and Results: This prospective, multicenter, randomized controlled trial included 420 patients with chronic kidney disease who underwent cardiovascular catheterization. They were assigned to receive high-dose pitavastatin (4 mg/day × 4 days) on the day before and of the procedure and 2 days after the procedure (Statin group, n=213) or no pitavastatin (Control group, n=207). Isotonic saline hydration combined with a single bolus of sodium bicarbonate (20 mEq) was scheduled for administration to all patients. In the control group, statin therapy was continued at the same dose as that before randomization. CIN was defined as a ≥0.5 mg/dL increase in serum creatinine or ≥25% above baseline at 48 h after contrast exposure. Before randomization, 83% of study participants were receiving statin treatment. The statin group had a higher incidence of CIN than the control group (3.0% vs. 0%, P=0.01). The 12-month rate of major adverse cardiovascular events was similar between the 2 groups.

Conclusions: High-dose pitavastatin increases the incidence of CIN in this study population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1253/circj.CJ-21-0869DOI Listing
April 2022

Growth and photosynthetic responses to ozone of Siebold's beech seedlings grown under elevated CO and soil nitrogen supply.

Environ Pollut 2022 Jul 28;304:119233. Epub 2022 Mar 28.

Institute of Agriculture, Tokyo University of Agriculture and Technology, Fuchu, Tokyo 183-8509, Japan. Electronic address:

Ozone (O) is a phytotoxic air pollutant, the adverse effects of which on growth and photosynthesis are modified by other environmental factors. In this study, we examined the combined effects of O, elevated CO, and soil nitrogen supply on Siebold's beech seedlings. Seedlings were grown under combinations of two levels of O (low and two times ambient O concentration), two levels of CO (ambient and 700 ppm), and three levels of soil nitrogen supply (0, 50, and 100 kg N ha year) during two growing seasons (2019 and 2020), with leaf photosynthetic traits being determined during the second season. We found that elevated CO ameliorated O-induced reductions in photosynthetic activity, whereas the negative effects of O on photosynthetic traits were enhanced by soil nitrogen supply. We observed three-factor interactions in photosynthetic traits, with the ameliorative effects of elevated CO on O-induced reductions in the maximum rate of carboxylation being more pronounced under high than under low soil nitrogen conditions in July. In contrast, elevated CO-induced amelioration of the effects of O on stomatal function-related traits was more pronounced under low soil nitrogen conditions. Although we observed several two- or three-factor interactions of gas and soil treatments with respect to leaf photosynthetic traits, the shoot to root dry mass (S/R) ratio was the only parameter for which a significant interaction was detected among seedling growth parameters. O caused a significant increase in S/R under ambient CO conditions, whereas no similar effects were observed under elevated CO conditions. Collectively, our findings reveal the complex interactive effects of elevated CO and soil nitrogen supply on the detrimental effects of O on leaf photosynthetic traits, and highlight the importance of taking into consideration differences between the responses of CO uptake and growth to these three environmental factors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.envpol.2022.119233DOI Listing
July 2022

Corrigendum: Lower Masticatory Performance Is a Risk for the Development of the Metabolic Syndrome: The Suita Study.

Front Cardiovasc Med 2022 3;9:872326. Epub 2022 Mar 3.

Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan.

[This corrects the article DOI: 10.3389/fcvm.2021.752667.].
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fcvm.2022.872326DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8928729PMC
March 2022

Prognosis of Coronary Artery Bypass Grafting in Preschool-Aged Patients with Myocardial Ischemia Due to Giant Aneurysm of Kawasaki Disease.

J Clin Med 2022 Mar 4;11(5). Epub 2022 Mar 4.

Department of Pediatrics, Nippon Medical School, Tokyo 113-8603, Japan.

Coronary artery bypass grafting (CABG) for severe cardiac sequelae of Kawasaki disease (KD) complicated by myocardial ischemia is feasible even in childhood. However, no report has summarized the prognosis of CABG in preschool-aged children. Therefore, we evaluated the outcomes of seven preschool-aged children who underwent CABG for the cardiac sequelae of KD in our hospital. The median age at KD onset and CABG was 36 and 59 months, respectively. The median period from KD onset to CABG was 12 months. The median post-operative observation period was 108 months. CABG between the left internal thoracic artery and left anterior descending artery was performed in all patients. In all patients, postoperative cardiac catheter examination revealed good graft patency and no anastomotic stenosis. Further, pre-operative abnormality of coronary flow reserve returned to normal after CABG. Currently, only one patient is taking warfarin. Regarding school-life management, no patient has exercise limitations, except for one patient who had acute myocardial infarction before CABG. Further, the risk of graft stenosis or occlusion was evaluated in the included patients. However, no accidents have been reported to date, and myocardial ischemia and school-life management have improved. Thus, CABG is an effective treatment in preschool-aged children.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/jcm11051421DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910851PMC
March 2022

The preoperative geriatric nutritional risk index (GNRI) is an independent prognostic factor in elderly patients underwent curative resection for colorectal cancer.

Sci Rep 2022 03 7;12(1):3682. Epub 2022 Mar 7.

Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.

The world is becoming longer-lived, and the number of elderly colorectal cancer patients is increasing. It is very important to identify simple and inexpensive postoperative predictors in elderly colorectal cancer patients. The geriatric nutritional risk index (GNRI) is a marker of systemic nutrition and is associated with poor survival in various kinds of cancers. A few reports have investigated recurrence factors using preoperative GNRI with CRC (colorectal cancer) patients. This study aimed to investigate whether preoperative GNRI is associated with recurrence-free survival (RFS) and overall survival (OS) in elderly patients with CRC. This study retrospectively enrolled 259 patients with Stage I-III CRC who were more than 65 years old and underwent curative surgery at a single institution in 2012-2017. We classified them into low GNRI (RFS: ≤ 90.5, OS ≤ 101.1) group and high GNRI (RFS: > 90.5, OS > 101.1) group. Multivariable analyses showed low GNRI group was an independent risk factor for 3-year RFS (P = 0.006) and OS (P = 0.001) in the patients with CRC. Kaplan-Meier analysis showed 3-year RFS and 3-year OS were significantly worse in the low GNRI group than in high GNRI group (p = 0.001, 0.0037). A low-preoperative GNRI was significantly associated with a poor prognosis in elderly CRC patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-022-07540-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901671PMC
March 2022

Incidence of epicardial connections between the right pulmonary vein carina and right atrium during catheter ablation of atrial fibrillation: A comparison between the conventional method and unipolar signal modification.

J Arrhythm 2022 Feb 27;38(1):97-105. Epub 2021 Dec 27.

Department of Cardiovascular Medicine Nara Medical University Kashihara Japan.

Background: When performing an electrical isolation of ipsilateral pulmonary veins (PVs) for atrial fibrillation, physicians often need additional radiofrequency (RF) ablation in the carina region between the superior and inferior PVs to achieve a right PV isolation because of intercaval bundles between the right PVs and right atrium (RA). We compared the efficacy of a high-power and short-duration ablation guided by unipolar signal modification (UM) with the conventional method (CM) for ablating epicardial connections between the right PV carina and RA.

Methods: The study subjects consisted of patients who underwent an initial box isolation of atrial fibrillation from January 2015 to December 2019 at Nara Medical University Hospital. Among these patients, 94 and 65 patients who met the criteria were assigned to the CM and UM groups, respectively. We retrospectively analyzed the anterior ablation line of the right PV using an electroanatomical mapping system. Patients whose initial ablation line included the right PV carina were excluded.

Results: Six and seven patients were, respectively, excluded from the CM and UM groups. Among 88 CM group patients, 21 needed additional right PV carina ablation, while among 58 UM group patients, 30 needed additional right PV carina ablation ( = .001). No anatomical factors were associated with the additional right PV carina ablation.

Conclusions: Compared to the CM group, a box isolation was less achievable without RF ablation at the right PV carina in the UM group. We should consider a long-duration ablation for epicardial connections between the right PV carina and RA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/joa3.12672DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8851570PMC
February 2022

Peripheral Coronary Artery Circulatory Dysfunction in Remote Stage Kawasaki Disease Patients Detected by Adenosine Stress N-Ammonia Myocardial Perfusion Positron Emission Tomography.

J Clin Med 2022 Feb 21;11(4). Epub 2022 Feb 21.

Department of Pediatrics, Nippon Medical School, 1-1-3 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.

Coronary peripheral circulatory disturbances in the remote stage of Kawasaki disease have been reported. In this study, of the 50 patients in the remote stage of Kawasaki disease who underwent coronary perfusion evaluation using adenosine-loaded N-ammonia positron emission tomography, 28 patients who did not have stenosis of ≥75% in the left coronary artery underwent an evaluation for myocardial flow reserve (MFR) of the left anterior descending artery (LAD) and left circumflex artery (LCx). Clinical findings were compared between patients with normal (≥2.0) and abnormal (<2.0) MFRs. In the group with an abnormal MFR in the LAD, the responsiveness of the coronary vascular resistance to adenosine stress decreased even in the LCx (3.50 ± 1.23 vs. 2.39 ± 0.25, = 0.0100). In the group with an abnormal MFR in the LCx, the responsiveness of the coronary vascular resistance in the LAD also decreased (3.27 ± 1.39 vs. 2.03 ± 0.25, = 0.0105), and the age of onset of Kawasaki disease tended to be younger in the group with abnormal MFR in the LAD and LCx. We found that the peripheral coronary circulation was extensively impaired in the remote stage of Kawasaki disease, suggesting that an early onset of Kawasaki disease may affect the peripheral coronary circulation in later years.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/jcm11041134DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8879565PMC
February 2022

Clinical relevance of impaired consciousness in accidental hypothermia: a Japanese multicenter retrospective study.

Acute Med Surg 2022 Jan-Dec;9(1):e730. Epub 2022 Feb 11.

Department of Emergency Medicine Kyoto Prefectural University of Medicine Kyoto Japan.

Aim: This study aimed to investigate the association between level of impaired consciousness and severe hypothermia (<28°C) and to evaluate the association between level of impaired consciousness and inhospital mortality among accidental hypothermia patients.

Methods: This was a multicenter retrospective study using the J-Point registry database, which includes data regarding patients whose core body temperature was 35.0°C or less and who were treated as accidental hypothermia in emergency departments between April 1, 2011 and March 31, 2016. We estimated adjusted odds ratios of the level of impaired consciousness for severe hypothermia less than 28°C and inhospital mortality using a logistic regression model.

Results: The study included 505 of 572 patients in the J-Point registry. Relative to mildly impaired consciousness (Glasgow Coma Scale [GCS] 13-15), the adjusted odds ratios for severe hypothermia less than 28°C were: moderate (GCS 9-12), 3.26 (95% confidence interval [CI], 1.69-6.25); and severe (GCS < 9), 4.68 (95% CI, 2.40-9.14). Relative to mildly impaired consciousness (GCS 13-15), the adjusted odds ratios for inhospital mortality were: moderate (GCS9-12), 1.65 (95% CI, 0.95-2.88); and severe (GCS < 9), 2.10 (95% CI, 1.17-3.78).

Conclusion: The level of impaired consciousness in patients with accidental hypothermia was associated with severe hypothermia and inhospital mortality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ams2.730DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836211PMC
February 2022

Relationship between the locomotive syndrome and kinetic and kinematic parameters during static standing and level walking.

Gait Posture 2022 03 22;93:146-152. Epub 2022 Jan 22.

Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo Hospital, Tokyo, Japan.

Background: Individuals experiencing age-related decline in locomotor functions are at high-risk of developing locomotive syndrome (LS). LS requires long-term care and greatly influences the quality of life and activities of daily living. The LS risk test was established as a diagnostic criterion by the Japanese Orthopedic Association. Although the relationship between the test and motor function has been established, few studies have reported on the characteristics of LS kinematically and kinetically.

Research Question: Do elderly with LS show different kinetic and kinematic characteristics compared with healthy elderly during static standing and level walking?

Methods: Forty-four Participants were divided into an LS group and a non-LS group based on the scores of the LS risk test. The standing posture and walking of the participants were measured using a three-dimensional motion capture system. The results of the groups were compared using an unpaired t-test, and then the characteristics of the LS group were extracted using logistic regression analysis.

Results: LS group exhibited trunk flexion during both standing and gait. A higher intervertebral disc compressive force, which is the index of the low-back mechanical stress, during standing and an increase in ankle plantarflexion angle during walking were observed in LS group.

Significance: This study determined the kinematic and kinetic features of elderly with LS. The findings suggest that parameters related to the trunk and ankle could be associated with LS. Further studying the characteristics of LS in older adults via motion analysis can help develop prevention and intervention methods for LS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.gaitpost.2022.01.017DOI Listing
March 2022

Increased Transumbilical Incision Complication Rates With Laparoscopic Colorectal Resection: A Single-center Propensity Score-matched Cohort Study.

Anticancer Res 2022 Feb;42(2):1115-1121

Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Shinagawa, Japan.

Aim: To evaluate the complication rates and risk factors associated with transumbilical incision (TUI) and comprehensively examine differences according to the procedures using propensity score matching.

Patients And Methods: The study involved 737 patients who underwent laparoscopic procedures between 2009 and 2017 (Japanese University-Hospital-Medical-Information-Network Clinical Trials Resistry No. 000040653). The occurrences of superficial surgical site infection (SSI) and TUI hernia were analyzed.

Results: SSI occurred in 17 patients (2.31%) and hernia occurred in 29 (3.93%). Multivariate analysis revealed that female sex and diabetes mellitus were correlated with incisional hernia. Propensity score-matching analysis was performed to compare those who underwent colorectal resection with those who underwent other resections; the results showed that the former had a significantly higher rate of TUI hernia (p<0.001), as well as a significantly higher incidence of SSI (p=0.004).

Conclusion: A significant higher incidence of SSI and TUI hernia in laparoscopic colorectal resection was found. The construction of the TUI was feasible with rationality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21873/anticanres.15574DOI Listing
February 2022

Clinical Course of Optical Coherence Tomography-Detected Lipid-Rich Coronary Plaque After Optimal Medical Therapy.

Circ Rep 2022 Jan 3;4(1):29-37. Epub 2021 Dec 3.

Cardiovascular Medicine, Nara Medical University Kashihara Japan.

The aim of this study was to evaluate optical coherence tomography (OCT)-detected lipid-rich coronary plaques (LRCPs) with coronary computed tomography angiography (CCTA) 10 months after optimal medical therapy (OMT). Baseline OCT detected 28 LRCPs in non-culprit lesions. High-risk plaque features (HRPFs), such as positive remodeling, very low attenuation plaques, napkin-ring sign, and spotty calcification, were observed in 67.9%, 67.9%, 21.4%, and 64.3% of LRCPs, respectively, at the 10-month follow-up CCTA. Lesions with ≥3 HRPFs were defined as high-risk LRCPs (n=12); the remaining were defined as low-risk LRCPs (n=16). The maximum lipid arc on baseline OCT was larger in high- than low-risk LRCPs (221±62° vs. 179±44°, respectively; P=0.04). Receiver operating characteristic curve analysis indicated that a maximum lipid arc >154° on baseline OCT was the optimal cut-off value to predict high-risk LRCPs 10 months after OMT. Patients with high-risk LRCPs had worse clinical outcomes, defined as a composite of cardiac death, target lesion-related myocardial infarction, and target lesion-related revascularization, during follow-up than those with low-risk LRCPs (33.3% vs. 0%; P=0.01). A high-risk LRCP at follow-up CCTA was correlated with a larger maximum lipid arc on baseline OCT. Further aggressive treatment for patients with large LRCPs may reduce vulnerable plaque features and prevent future cardiac events.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1253/circrep.CR-21-0147DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8710641PMC
January 2022

Surgical treatment for a recurrent defect 22 years after inferior sinus venosus defect closure: A case report.

J Nippon Med Sch 2022 Jan 25. Epub 2022 Jan 25.

Department of Cardiovascular Surgery, Nippon Medical School.

Background: Residual shunt after the closure of an inferior sinus venosus defect (ISVD) is a rare complication with a high rate of reintervention.

Case Presentation: Here, we report a rare case of a patient with a recurrent defect identified 22 years after the closure of ISVD. The 25 × 10-mm defect was situated at the inferior vena cava-right atrial junction and was closed directly at 5 years of age. No residual shunt was detected, and when the patient reached 12 years of age, follow-up was discontinued. However, the residual atrial septal defect shunt was detected incidentally at 27 years of age. During the second surgery, the lower end of the original defect was opened and then closed using an expanded polytetrafluoroethylene patch.

Conclusions: In light of the high rate of reintervention for residual shunt after ISVD closure, patch closure appeared to be a better option to reduce the tension in the inferior-posterior border. Moreover patients with this profile should be followed up closely at least in their childhood, including assessment by echocardiography.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1272/jnms.JNMS.2023_90-301DOI Listing
January 2022

Outcomes of catecholamine and/or mechanical support in Takotsubo syndrome.

Heart 2022 Jan 19. Epub 2022 Jan 19.

Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Nara, Japan

Objective: This study aimed to reveal the clinical characteristics of patients with severe Takotsubo syndrome (TTS) who needed catecholamine support (CS) or mechanical support (MS) and to identify factors associated with serious illness and in-hospital mortality.

Methods: This was a nationwide retrospective study that used claims data from the Japanese registry of all cardiac and vascular diseases and the diagnosis procedure combination registry, from April 2012 to March 2016. The patients with TTS were divided into severe TTS and mild TTS groups. The severe group was defined as patients who needed CS and/or MS.

Results: Among 6169 patients with TTS, 1148 (18.6%) had severe TTS. No significant difference in age was found between the two groups; however, the number of female patients was significantly lower in the severe group than in the mild group. Among 130 patients who underwent MS, 22 and 108 patients required MS alone and both MS and CS, respectively. The 30-day mortality rate was significantly higher in the severe group than in the mild group (11.4% vs 2.6%, p<0.01) and increased with age. Of the patients with severe TTS, 65.6% died within 7 days. Multivariable analysis showed that male sex (OR 1.22, p=0.03), higher Charlson scores (OR 1.11, p<0.01), comorbid pneumonia (OR 1.68, p<0.01), comorbid sepsis (OR 6.02, p<0.01) and ambulance use (OR 2.01, p<0.01) were associated with severe TTS.

Conclusions: The rate of severe TTS was 18.6% among 6169 patients registered in the Japanese nationwide database, and the 30-day mortality was higher in patients with severe TTS than in those with mild TTS (11.4% vs 2.6%).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/heartjnl-2021-319904DOI Listing
January 2022

Mild Hypertensive Retinopathy and Risk of Cardiovascular Disease: The Suita Study.

J Atheroscler Thromb 2022 Jan 15. Epub 2022 Jan 15.

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.

Aims: This study aimed to investigate the association of mild hypertensive retinopathy with cardiovascular disease (CVD) risk.

Methods: A total of 7,027 residents aged 30-79 years without a history of CVD participated in the annual health checkups and retinal photography assessments. Retinal microvascular abnormalities were graded using the standard protocols and classified according to the Keith-Wagener-Barker classification. Mild hypertensive retinopathy was defined as grades 1 and 2. Cox proportional hazard model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for total CVD and its subtypes according to the presence and absence of mild hypertensive retinopathy.

Results: During a median follow-up of 17 years, 351 incident stroke and 247 coronary heart disease (CHD) cases were diagnosed. After adjustment for traditional cardiovascular risk factors, mild hypertensive retinopathy was positively associated with risk of CVD (multivariable HR=1.24; 95% CI, 1.04-1.49) and stroke (1.28; 1.01-1.62) but not with risk of CHD (1.19; 0.89-1.58). Generalized arteriolar narrowing and enhanced arteriolar wall reflex were positively associated with CVD risk, the multivariable HR (95% CI) was 1.24 (1.00- 1.54)and 1.33 (1.02-1.74), respectively. Moreover, mild hypertensive retinopathy was positively associated with stroke risk in normotensive participants.

Conclusion: Mild hypertensive retinopathy was positively associated with CVD and stroke risk in the urban Japanese population. Especially, generalized arteriolar narrowing and enhanced arteriolar wall reflex were positively associated with CVD risk. These findings suggested that retinal photography could be helpful for cardiovascular risk stratification in the primary cardiovascular prevention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5551/jat.63317DOI Listing
January 2022

Detection of myocardial bridge by optical coherence tomography.

Int J Cardiovasc Imaging 2022 Jan 11. Epub 2022 Jan 11.

Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Japan.

Myocardial bridge (MB) is less commonly documented by angiography than autopsy. Optical coherence tomography (OCT) may be useful to detect angiographically undetectable MB. To investigate OCT characteristics of MB, 86 LAD vessels were imaged by OCT. MB was defined as presence of intermediate optical intensity, "fine" layer surrounding coronary artery by OCT. Frequency and characteristics of the angio-detectable and angio-undetectable but OCT-detectable MB were investigated. In a subset of patients with angio-detectable MB, cyclic changes in coronary arterial dimensions were analyzed. OCT detected MB in 44 of 86 (51%). Arc of the MB was significantly larger (334.8 ± 58.5° vs. 268.4 ± 92.1°, P = 0.008) and length was significantly longer (22.6 ± 11.7 mm vs. 14.5 ± 8.1 mm, P = 0.014) in angio-detectable MB than OCT-detectable but angio-undetectable MB. Both vessel (6.8 ± 1.5 to 5.3 ± 1.0 mm, P = 0.035) and lumen area (4.4 ± 1.5 to 3.1 ± 0.7 mm, P = 0.040) decreased significantly from diastole to systole. Adventitial (0.08 ± 0.03 to 0.08 ± 0.02 mm, P = 0.828) and intima + plaque thickness (0.12 ± 0.05 to 0.10 ± 0.03 mm, P = 0.398) did not change significantly during cardiac cycle. On the other hand, medial thickness increased significantly from diastole to systole (0.08 ± 0.03 to 0.12 ± 0.03 mm, P = 0.022). In conclusion, MB is frequently detected as intermediate intensity, fine layer by OCT. During systole, vessel and lumen size decrease with increased medial thickness. Therefore, we should be careful for OCT interpretation of the coronary arteries with MB.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10554-021-02497-5DOI Listing
January 2022

Relationship between maximum occlusal force and gastrointestinal cancer in community-dwelling older Japanese adults.

Sci Rep 2022 01 10;12(1):440. Epub 2022 Jan 10.

Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.

Globally, the cancer burden is expected to increase as populations are ageing. Therefore, cancer prevention among older age groups is important. This prospective cohort study examined the relationship between the number of remaining teeth, maximum occlusal force, and incidence of gastrointestinal cancer in community-dwelling older Japanese individuals using data from the Tsurugaya project; 847 participants were included. The exposure variables were the number of remaining teeth and the maximum occlusal force, with the outcome being the incidence of gastrointestinal cancer. Covariates were age, sex, medical history, smoking, alcohol consumption, educational attainment, and physical function. The Cox proportional hazard model was used to examine the relationship between the number of remaining teeth, maximum occlusal force, and incidence of gastrointestinal cancer. With a median follow-up of 7.6 years, 63 participants were confirmed to have gastrointestinal cancer. The risk of gastrointestinal cancer was significantly higher in those with an occlusal force lower than the median (hazard ratio, 2.80; 95% confidence interval, 1.54-5.10). No significant risk difference was found according to the number of remaining teeth. Low maximum occlusal force was associated with the incidence of gastrointestinal cancer in community-dwelling older Japanese adults.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-04158-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8748517PMC
January 2022

Incidence and characteristics of incomplete stent apposition in calcified lesions: An optical coherence tomography study.

Cardiovasc Revasc Med 2022 Jan 4. Epub 2022 Jan 4.

Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Japan.

Background: Persistent or late acquired incomplete stent apposition (ISA) may be associated with late or very late stent thrombosis following drug-eluting stent implantation. Presence of calcium at the target lesion may increase the risk of ISA even after rotational atherectomy (RA) followed by stenting with high pressure balloon inflation. The aim of this study is to examine the incidence and characteristics of ISA in heavily calcified lesions.

Methods: A total of 52 heavily calcified coronary artery lesions requiring RA plus stenting were selected and studied. After successful ablation followed by stent implantation, optical coherence tomography (OCT) was performed to assess stent expansion and apposition. Presence or absence of ISA was examined and maximal stent strut to vessel wall distance (max SV distance) was measured. In lesions with repeated OCT at follow-up, serial changes in ISA were investigated.

Results: ISA was documented in 51 of 52 (98%) lesions. Mean max SV distance was 713 ± 371 μm. In lesions with serial OCT images (n = 11), max SV distance decreased significantly (692.1 ± 420.2 to 462.5 ± 387.0 μm, P < 0.01) but persisted in all but 2 lesions (82%).

Conclusions: ISA is frequently documented in heavily calcified lesions requiring RA. Significant ISA still persisted with minimal improvement in SV distance at follow-up. Prognostic impact of the persistent ISA in such calcified lesions needs further investigations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.carrev.2021.12.032DOI Listing
January 2022

Increased Plasma Soluble PD-1 Concentration Correlates with Disease Progression in Patients with Cancer Treated with Anti-PD-1 Antibodies.

Biomedicines 2021 Dec 16;9(12). Epub 2021 Dec 16.

Department of Clinical Diagnostic Oncology, Clinical Research Institute for Clinical Pharmacology & Therapeutics, Showa University, 6-11-11, Kitakarasuyama, Setagaya-ku, Tokyo 157-8577, Japan.

Immune checkpoint inhibitors (ICIs) confer remarkable therapeutic benefits to patients with various cancers. However, many patients are non-responders or develop resistance following an initial response to ICIs. There are no reliable biomarkers to predict the therapeutic effect of ICIs. Therefore, this study investigated the clinical implications of plasma levels of soluble anti-programmed death-1 (sPD-1) in patients with cancer treated with ICIs. In total, 22 patients (13 with non-small-cell lung carcinoma, 8 with gastric cancer, and 1 with bladder cancer) were evaluated for sPD-1 concentration using enzyme-linked immunosorbent assays for diagnostic and anti-PD-1 antibody analyses. sPD-1 levels were low before the administration of anti-PD-1 antibodies. After two and four cycles of anti-PD-1 antibody therapy, sPD-1 levels significantly increased compared with pretreatment levels ( = 0.0348 vs. 0.0232). We observed an increased rate of change in plasma sPD-1 concentrations after two and four cycles of anti-PD-1 antibody therapy that significantly correlated with tumor size progression ( = 0.024). sPD-1 may be involved in resistance to anti-PD-1 antibody therapy, suggesting that changes in sPD-1 levels can identify primary ICI non-responders early in treatment. Detailed analysis of each cancer type revealed the potential of sPD-1 as a predictive biomarker of response to ICI treatment in patients with cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/biomedicines9121929DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8698555PMC
December 2021

Comparison of Endotoxin Activity Assay and Various Biomarkers for Severity Assessment in Colorectal Perforation Patients.

Am Surg 2021 Dec 17:31348211056256. Epub 2021 Dec 17.

Esophageal Cancer Center, 13059Showa University, Tokyo, Japan.

Colorectal perforation is a serious disease with high mortality requiring emergency surgery. This study aimed to evaluate the role of the endotoxin activity assay (EAA) to assess the severity in patients admitted to the intensive care unit after emergency surgeries for colorectal perforations. Patients were divided into high (EAA ≥.4) and low (EAA <.4) groups based on the EAA levels, and the correlation between the EAA values and clinical variables related to the severity was evaluated. The SOFA scores were significantly higher in the high group than those in the low group. The high EAA value persisted even after 48 hours and extended the ICU length of stay. These results suggest that EAA may be a potential biomarker to assess severity and useful as one of the instrumental in predicting the outcomes for colorectal perforation patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/00031348211056256DOI Listing
December 2021

Lower Masticatory Performance Is a Risk for the Development of the Metabolic Syndrome: The Suita Study.

Front Cardiovasc Med 2021 26;8:752667. Epub 2021 Nov 26.

Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Japan.

Declined masticatory function has recently been receiving attention as a risk factor for poor general health. The present longitudinal analysis was conducted to clarify the relationship between decreased masticatory performance and the development of the metabolic syndrome (MetS) in a general urban cohort in Japan. We surveyed 599 participants (254 men, 345 women; mean age at baseline, 65.8 ± 7.8 years) who underwent physical health checkups in the Suita study. We evaluated masticatory performance at baseline using test gummy jelly and divided participants into two groups: a "Lower group," comprising participants in the lower 25% of the masticatory performance at baseline; and a "Normal group," comprising all others. We estimated hazard ratios (HRs) for the Lower group by using Cox proportional hazard regression analysis to develop the MetS and the components of the MetS at follow-up, adjusting for age, smoking status, and periodontal status. On Cox proportional hazard regression analysis, the multivariable adjusted hazard ratio for the development of the MetS in the Lower group was 2.24 (95% confidence interval, 1.12-4.50) in men. The multivariable adjusted hazard ratio for the development of high blood pressure was 3.12 (1.42-6.87), for high triglycerides was 2.82 (1.18-6.76), and for high fasting plasma glucose was 2.65 (1.00-7.00) in men. Lower masticatory performance suggested to be a risk factor for the development of the MetS as well as MetS components such as high blood pressure, high triglycerides, and high fasting plasma glucose in Japanese men.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fcvm.2021.752667DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8661002PMC
November 2021

ELOVL2 promotes cancer progression by inhibiting cell apoptosis in renal cell carcinoma.

Oncol Rep 2022 Feb 29;47(2). Epub 2021 Nov 29.

Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305‑8577, Japan.

Renal cell carcinoma (RCC) is an aggressive genitourinary malignancy which has been associated with a poor prognosis, particularly in patients with metastasis, its major subtypes being clear cell RCC (ccRCC), papillary PCC (pRCC) and chromophobe RCC (chRCC). The presence of intracellular lipid droplets (LDs) is considered to be a hallmark of ccRCC. The importance of an altered lipid metabolism in ccRCC has been widely recognized. The elongation of very‑long‑chain fatty acid (ELOVL) catalyzes the elongation of fatty acids (FAs), modulating lipid composition, and is required for normal bodily functions. However, the involvement of elongases in RCC remains unclear. In the present study, the expression of ELOVL2 in ccRCC was examined; in particular, high levels of seven ELOVL isozymes were observed in primary tumors. Of note, elevated ELOVL2 expression levels were observed in ccRCC, as well as in pRCC and chRCC. Furthermore, a higher level of ELOVL2 was significantly associated with the increased incidence of a poor prognosis of patients with ccRCC and pRCC. The CRISPR/Cas9‑mediated knockdown of ELOVL2 resulted in the suppression of the elongation of long‑chain polyunsaturated FAs and increased LD production in renal cancer cells. Moreover, ELOVL2 ablation resulted in the suppression of cellular proliferation via the induction of apoptosis and the attenuation of tumor growth . On the whole, the present study provides new insight into the tumor proliferation mechanisms involving lipid metabolism, and suggests that ELOVL2 may be an attractive novel target for RCC therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/or.2021.8234DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8674704PMC
February 2022

Impact of cooling method on the outcome of initial shockable or non-shockable out of hospital cardiac arrest patients receiving target temperature management: a nationwide multicentre cohort study.

Ann Intensive Care 2021 Nov 26;11(1):163. Epub 2021 Nov 26.

Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, 602-8566, Japan.

Background: Little is known about the effectiveness of surface cooling (SC) and endovascular cooling (EC) on the outcome of out-of-hospital cardiac arrest (OHCA) patients receiving target temperature management (TTM) according to their initial rhythm.

Methods: We retrospectively analysed data from the Japanese Association for Acute Medicine Out-of-Hospital Cardiac Arrest registry, a multicentre, prospective nationwide database in Japan. For our analysis, OHCA patients aged ≥ 18 years who were treated with TTM between June 2014 and December 2017 were included. The primary outcome was 30-day survival with favourable neurological outcome defined as a Glasgow-Pittsburgh cerebral performance category score of 1 or 2. Cooling methods were divided into the following groups: SC (ice packs, fans, air blankets, and surface gel pads) and EC (endovascular catheters and any dialysis technique). We investigated the efficacy of the two categories of cooling methods in two different patient groups divided according to their initially documented rhythm at the scene (shockable or non-shockable) using multivariable logistic regression analysis and propensity score analysis with inverse probability weighting (IPW).

Results: In the final analysis, 1082 patients were included. Of these, 513 (47.4%) had an initial shockable rhythm and 569 (52.6%) had an initial non-shockable rhythm. The proportion of patients with favourable neurological outcomes in SC and EC was 59.9% vs. 58.3% (264/441 vs. 42/72), and 11.8% (58/490) vs. 21.5% (17/79) in the initial shockable patients and the initial non-shockable patients, respectively. In the multivariable logistic regression analysis, differences between the two cooling methods were not observed among the initial shockable patients (adjusted odd ratio [AOR] 1.51, 95% CI 0.76-3.03), while EC was associated with better neurological outcome among the initial non-shockable patients (AOR 2.21, 95% CI 1.19-4.11). This association was constant in propensity score analysis with IPW (OR 1.40, 95% CI 0.83-2.36; OR 1.87, 95% CI 1.01-3.47 among the initial shockable and non-shockable patients, respectively).

Conclusion: We suggested that the use of EC was associated with better neurological outcomes in OHCA patients with initial non-shockable rhythm, but not in those with initial shockable rhythm. A TTM implementation strategy based on initial rhythm may be important.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13613-021-00953-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8626556PMC
November 2021

Catheter ablation of ganglionated plexi in patients with adenosine triphosphate-induced atrial fibrillation after pulmonary vein isolation.

Heart Vessels 2022 May 6;37(5):854-866. Epub 2021 Nov 6.

Department of Cardiovascular Medicine, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8522, Japan.

Intravenous ATP may induce atrial fibrillation (AF). ATP shares similar receptor-effector coupling systems with acetylcholine. However, the association between an ATP injection and the hyperactivity of the intrinsic cardiac autonomic nervous system, known as ganglionated plexi (GPs), is not well understood. We describe a series of patients with non-pulmonary vein (PV) trigger sites provoked by an ATP injection, and assess the feasibility of a ganglionated plexus (GP) ablation. We retrospectively analyzed 547 patients (69% male; mean age 67.4 ± 10.4 years; 38.5% non-paroxysmal AF) who underwent a total of 604 ablation procedures. Intravenous ATP was administered with an isoproterenol infusion during sinus rhythm after a pulmonary vein isolation in 21.3%, Box isolation in 78.6%, and SVC isolation in 52.0% of the procedures, respectively. We reviewed the incidence, the distribution of the foci, and the ablation outcomes in patients with ATP-induced AF. A total of seven patients (1.3%) had ATP-induced AF. Foci were identified in the coronary sinus (CS) in six patients, right atrial posterior wall (RAPW) adjacent to the interatrial groove in two, mitral annulus in two, ligament of Marshall in one, right septum below the foramen ovale in one and left atrial posterior wall in one, respectively. Among these trigger foci, we confirmed the vagal response by high-frequency stimulation in the CS and RAPW in six and two patients, respectively. After a median RF time of 2.9 min (range 2.5-11.3) targeting these foci, in five of six patients who received a repeat ATP injection, the AF became non-inducible. ATP-provoked trigger foci were distributed among certain sites that overlapped with the distribution of the GPs. The GP ablation was effective for this rare, but challenging situation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00380-021-01979-9DOI Listing
May 2022

Clinical Treatment of Perioperative Disseminated Intravascular Coagulation in Patients Who Underwent Gastrointestinal and Hepato-Biliary-Pancreatic Surgery.

Am Surg 2021 Nov 3:31348211054702. Epub 2021 Nov 3.

Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, 13059Showa University, Shinagawa, Tokyo, Japan.

Background: It is unclear how effective recombinant thrombomodulin (rTM) treatment is in disseminated intravascular coagulation (DIC) during the perioperative period of gastrointestinal and hepato-biliary-pancreatic surgery. The current study aimed to evaluate the therapeutic outcomes of rTM for perioperative DIC.

Methods: We enrolled 100 consecutive patients diagnosed with perioperative DIC after gastrointestinal surgery, and hepato-biliary-pancreatic including emergency procedures, between January 2012 and May 2021. Patients received routine rTM treatment immediately after DIC diagnosis. Then, the DIC, Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were calculated and used for evaluation. The outcomes of rTM treatment and the predictors of survival were evaluated.

Results: The causative diseases of DIC were as follows: perforated peritonitis, n = 38; intestinal ischemia, n = 23; intra-abdominal abscess, n = 13; anastomotic leakage, n = 7; pneumonia, n = 7; cholangitis, n = 4; and others, n = 6. The 30-day mortality rate was 18.0%. There were significant differences in the platelet count (13.78 vs 10.41, P = .032) and the SOFA score (5.22 vs 9.89, P<.0001) at the start of DIC treatment between the survivor and non-survivor groups (day 0). The survivor group had a significantly lower DIC score (3.13 vs 4.93, P = .0006) and SOFA score (4.94 vs 12.14, P < .0001) and a higher platelet count (13.50 vs 4.34, P < .0001) than the non-survivor group on day 3.

Conclusions: Comprehensive and systemic treatment is fundamentally essential for DIC, in which rTM may play an important role in the treatment of perioperative DIC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/00031348211054702DOI Listing
November 2021

Prevalence of mitral annular calcification and its association with mitral valvular disease.

Echocardiography 2021 11 30;38(11):1907-1912. Epub 2021 Oct 30.

Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Japan.

Background: Mitral annular calcification (MAC) is increasingly observed in elderly population. The purpose of this study was to investigate incidence of MAC and its association with mitral valvular disease (MVD).

Methods: A total of 13,483 consecutive patients who underwent echocardiography were enrolled. MAC was defined as an echo-dense, shelf-like structure with an irregular, lumpy appearance involving the mitral valve annulus, with acoustic shadowing. Prevalence of MAC and its association with significant mitral stenosis (MS) or mitral regurgitation (MR) were studied. Significant (≥moderate) MS was defined as mean transmitral valvular pressure gradient > 5 mm Hg and significant MR was defined as ≥moderate MR based on quantitative or semi-quantitative Doppler methods.

Results: MAC was present in 1881 of 13,483 patients (14%). Patients with MAC (MAC group) was older and more female gender than those without MAC (non-MAC group). Significant MS was present in 2.2% of MAC and in .6% of the non-MAC group (p < 0.0001). Significant MR was present in 11.9% of MAC and in 5.0% of the non-MAC group (p < 0.0001). Co-existence of MAC and aortic valve replacement (AVR) was associated with increased prevalence of MVD (MS:11.4%, MR:17.2%, respectively).

Conclusion: MAC was present in 14% of the patients and was associated with significant MVD. Co-existence of MAC and AVR may increase the risk of MVD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/echo.15236DOI Listing
November 2021

Uric acid and incident atrial fibrillation of 14 years population-based cohort study: The Suita Study.

J Arrhythm 2021 Oct 11;37(5):1215-1219. Epub 2021 Aug 11.

Department of Preventive Cardiology National Cerebral and Cardiovascular Center Suita Japan.

Background: Higher baseline uric acid (UA) was significantly associated with higher atrial fibrillation (AF) incidence in Japanese women. However, no prospective study is evident in the association between UA and incident AF in Japanese urban residents.

Methods: A total of 6863 participants (aged 30-79 years; 47% men) without prior AF were followed for 13.9 years on average in the Suita Study. According to the UA categories, cox proportional hazards regression models were used to estimating the Hazard Ratios (HRs) and 95% confidence intervals (CIs) for incident AF.

Results: During 95178 person-years of follow-up, we observed 311 cases of incident AF (204 cases in men and 107 cases in women). Compared to the subjects with UA of 4.0-4.9 mg/dL, multivariable-adjusted HR (95% CIs) of incident AF was 1.50 (1.01-2.25) ( = .047) for the subjects with UA ≥7.0 mg/dL.

Conclusion: High UA was associated with an increased risk for incident AF in the Japanese population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/joa3.12612DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8485815PMC
October 2021
-->