著者

Hiroki Usuku Eiichiro Yamamoto Masato Nishi Takashi Komorita Masafumi Takae Taiki Nishihara Fumi Oike Masanobu Ishii Koichiro Fujisue Daisuke Sueta Satoshi Araki Seiji Takashio Seitaro Oda Yohei Misumi Mitsuharu Ueda Taishi Nakamura Hiroaki Kawano Hirofumi Soejima Kenji Sakamoto Koichi Kaikita Yukio Ando Hirotaka Matsui Kenichi Tsujita

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.2, no.12, pp.730-738, 2020-12-10 (Released:2020-12-10)

参考文献数

27

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Background:Using transthoracic echocardiography, including 2D speckle tracking imaging (STI), this study examined cardiac function after domino liver transplantation (DLT) with liver grafts explanted from patients with hereditary amyloidogenic transthyretin amyloidosis.Methods and Results:In all, 14 patients who underwent DLT at Kumamoto University Hospital and for whom 2D STI information was available were enrolled in the study; time-dependent echocardiographic changes were evaluated in 7. Although left ventricular (LV) systolic and diastolic function did not differ between the pre- and post-DLT periods (mean [±SD] 5.4±1.0 years after DLT), there were significant (P<0.05 for all) increases in the post- vs. pre-DLT period in basal longitudinal strain (LS; −13.4±2.3 vs. −19.3±4.4), relative apical LS index (=apical LS/[basal LS+mid LS]; 0.75±0.20 vs. 0.58±0.08), and LV ejection fraction/global LS (3.91±0.58 vs. 3.06±0.44). Age at the time of DLT was significantly higher in the group with impaired (>−14%) than preserved basal LS (57.2±3.5 vs. 39.6±16.0 years; P<0.05). When control subjects (n=14) were added to the enrolled DLT recipients, multivariable logistic regression analysis revealed that a history of DLT was significantly associated with impaired basal LS (>−14%; odds ratio 28.39, 95% confidence interval 1.89–427.45, P<0.05).Conclusions:LV systolic and diastolic function was preserved in the long term after DLT. However, 2D STI revealed subtle cardiac dysfunction in DLT recipients, which may be an early manifestation of cardiac amyloidosis.

著者

Hiroki Usuku Eiichiro Yamamoto Fumi Oike Tatsuya Yoshinouchi Kanako Imamura Kenichi Yoshida Daisuke Kanesaki Yasuhiro Toma Ayako Tomita Yuji Ogata Seiki Matsumoto Yoshio Iwayama Tomoko Sassa Shinji Tanaka Yoko Fukuyoshi Tamami Matsumoto Eiichiro Tanaka Hiroyuki Shono Kazuhiro Nishigami Kenichi Tsujita Hirotaka Matsui

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.2, no.6, pp.297-305, 2020-06-10 (Released:2020-06-10)

参考文献数

17

被引用文献数

3

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Background:There are few reports on current awareness and status of transthoracic echocardiography (TTE), including the actual performance rate according to echocardiographic guidelines, in a specific area or region.Methods and Results:This cross-sectional survey study was conducted in Kumamoto Prefecture from October 2018 to March 2019. There are 366 medical institutions advocating cardiology in Kumamoto Prefecture. Of these, 259 (101 hospitals and 158 clinics) returned questionnaires regarding TTE. In all, 150,570 TTEs were performed in 2017. Of these, 132,771 (88%) were performed in hospitals and 17,799 (12%) were performed in clinics. Physicians performed only 5% of TTEs, whereas sonographers performed 86%. Although the modified Simpson method was performed in 90% of hospitals, 3-dimensional echocardiography was performed in only 2% of hospitals. In addition, the left atrial volume index was not examined in approximately 60% of hospitals, and the mean E/E′ ratio was not examined in 80% of hospitals. Multivariable logistic regression analysis revealed that having a Fellow of the Japan Society of Ultrasonic in Medicine was significantly and independently associated with guideline-oriented TTE (odds ratio 9.43; 95% confidence interval 1.22–72.71, P<0.05).Conclusions:The rate of echocardiographic measurements performed according to echocardiographic guidelines is exceptionally low in Kumamoto Prefecture. Sufficient dissemination of echocardiographic guidelines may be important in improving this rate.