著者

Azliza Mad Anuar Akira Minami Hiroshi Matsushita Kanako Ogino Kosei Fujita Hatsune Nakao Shota Kimura Vikineswary Sabaratnam Kaoru Umehara Yuuki Kurebayashi Tadanobu Takahashi Hiroaki Kanazawa Akihiko Wakatsuki Takashi Suzuki Hideyuki Takeuchi

出版者

The Pharmaceutical Society of Japan

雑誌

Biological and Pharmaceutical Bulletin (ISSN:09186158)

巻号頁・発行日

vol.45, no.10, pp.1438-1443, 2022-10-01 (Released:2022-10-01)

参考文献数

59

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Estrogen deficiency during menopause causes a variety of neurological symptoms, including depression. The edible Lion’s Mane mushroom, Hericium erinaceus (Bull.: Fr.) Pers. (HE), is a medicinal mushroom that has the potential for a neuroprotective effect and ameliorating neurological diseases, such as depression, anxiety, and neurodegenerative diseases. HE contains phytoestrogens, including daidzein and genistein. However, the ameliorating effect of HE on menopausal symptoms is not well understood. Here we investigated the impact of methanol extract of the HE fruiting body on depressive-like behavior in postmenopausal model rats. The activation of estrogen receptor alpha (ERα) causes body weight loss and uterine weight gain. Body weight gain and uterine weight loss by estrogen deficiency in ovariectomized (OVX) rats were reversed with 17β-estradiol (E2) but not with HE. Thus, the phytoestrogens in HE may hardly activate ERα. Estrogen receptor beta (ERβ) is expressed in the brain, and activation of ERβ ameliorates menopausal depressive symptoms. Notably, depressive-like behavior in OVX rats evaluated in forced swim test was reduced by administration of not only E2 but also HE for 92 d. Long-term activation of ERα increases the risk of breast and uterine cancers. HE, therefore, may be effective in treating menopausal depression without the risk of carcinogenesis caused by ERα activation.

著者

Takashi Nobusawa Hiroshi Yamatani Makoto Kusaba

出版者

Japanese Society for Plant Biotechnology

雑誌

Plant Biotechnology (ISSN:13424580)

巻号頁・発行日

vol.39, no.3, pp.317-321, 2022-09-25 (Released:2022-09-25)

参考文献数

25

被引用文献数

1

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Controlling the flowering time is crucial for propagating plant species and crop production. ALTERED MERISTEM PROGRAM1 (AMP1) in Arabidopsis thaliana encodes a putative carboxypeptidase, and an AMP1 mutant (amp1) was found to cause highly pleiotropic phenotypes including a short plastochron, an enlarged shoot apical meristem, and reduced apical dominance. Although amp1 also shows an early flowering phenotype, its mechanism has not been investigated in detail. The most important floral integrator or florigen gene, FLOWERING LOCUS T (FT), has a close relative, TWIN SISTER OF FT (TSF). In this report, we generated a new allele of tsf using a genome-editing technique and produced ft tsf double and amp1 ft tsf triple mutants. The flowering time of amp1 ft tsf was equally as late as ft tsf under long-day conditions. In addition, the expression level of FT in amp1 was 2.4-fold higher than that in wild-type, even five days after germination under long-day conditions. These results suggest that the elevated expression level of FT is responsible for the early flowering phenotype of amp1. Furthermore, expression of FLOWERING LOCUS C (FLC), a negative regulator of FT expression, is severely repressed in amp1, raising the possibility that low expression levels of FLC contributes to upregulation of FT expression and the early flowering phenotype of amp1.

著者

大関 健一 青柳 宏 Kenichi OZEKI Hiroshi AOYAGI

出版者

宇都宮大学共同教育学部

雑誌

宇都宮大学共同教育学部研究紀要.第1部 = The Research Bulletin of the Cooperative Faculty of Education Utsunomiya University. Section 1 (ISSN:24325546)

巻号頁・発行日

no.71, pp.251-292, 2021-03-31

著者

Atsushi FUKUDA Hiroshi OKAZAKI Shoichi NARAHASHI

出版者

The Institute of Electronics, Information and Communication Engineers

雑誌

IEICE TRANSACTIONS on Electronics (ISSN:09168516)

巻号頁・発行日

vol.E105-C, no.12, pp.740-749, 2022-12-01

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This paper presents a novel frequency-controlled beam steering scheme for a phased-array antenna system (PAS). The proposed scheme employs phase-controlled carrier signals to form the PAS beam. Two local oscillators (LOs) and delay lines are used to generate the carrier signals. The carrier of one LO is divided into branches, and then the divided carriers passing through the corresponding delay lines have the desired phase relationship, which depends on the oscillation frequency of the LO. To confirm the feasibility of the scheme, four-branch PAS transmitters are configured and tested in a 10-GHz frequency band. The results verify that the formed beam is successfully steered in a wide range, i.e., the 3-dB beamwidth of approximately 100 degrees, using LO frequency control.

著者

Hiroshi OTA

出版者

Japanese Educational Research Association

雑誌

Educational Studies in Japan (ISSN:18814832)

巻号頁・発行日

vol.12, pp.91-105, 2018 (Released:2018-10-17)

参考文献数

32

被引用文献数

18 46

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This paper discusses the meaning of the internationalization of higher education in Japan, based on a review of global trends in this area. Globalization has brought major changes to higher education, and in order to deal with them, the Japanese government has promoted internationalization as an important policy for higher education reform with a series of competitive funding programs. Universities in Japan, too, have made efforts to internationalize themselves. Despite the government's policy initiatives, the internationalization of Japanese higher education has not been understood as a high-priority issue at the institutional level, with many examples of superficial or partial add-ons of the international aspect, and has even been criticized as unable to contribute to transformative change at universities. Internationalization tends to be used as a means to prevail in the domestic competition between universities (inward-facing internationalization) and does not necessarily result in initiatives which lead to the improvement of learning in a globalized environment.All in all, the government's competitive funding projects for internationalization have indeed intensified domestic competition among universities. However, it is not certain that the funds have increased the international competitiveness and compatibility of Japanese higher education as a whole.

著者

SHIGEAKI AOYAGI SATORU TOBINAGA KUMIKO WADA SHIN-ICHI NATA HIROSHI YASUNAGA

出版者

Kurume University School of Medicine

雑誌

The Kurume Medical Journal (ISSN:00235679)

巻号頁・発行日

vol.67, no.2.3, pp.131-135, 2020-09-30 (Released:2022-11-16)

参考文献数

8

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Summary: Anomalous aortic origin of a coronary artery from the opposite sinus of Valsalva is known as a cause of sudden cardiac death. However, it is often asymptomatic and incidentally diagnosed during evaluation for other cardiac diseases. We report a case of anomalous aortic origin of the right coronary artery (RCA) from the left sinus of Valsalva (ARCA) detected incidentally in a patient with degenerative mitral regurgitation (MR). A 47-year-old man, who had no history of myocardial ischemic symptoms on exertion, was admitted for sudden orthopnea. ECG revealed no ischemic changes and arrhythmias. Echocardiography demonstrated MR due to torn chordae of the posterior mitral leaflet. Computed tomography (CT) revealed the RCA arising from the left sinus of Valsalva at an acute angle and taking an interarterial course between the great arteries. The proximal RCA showed a circular shaped cross-section on CT, suggesting no presence of an intramural segment. Considering refractory heart failure and no history of myocardial ischemic symptoms on exertion as well as the findings of the CT angiography, urgent mitral valve repair was undertaken without surgical intervention for the anomalous RCA, and without evaluating myocardial ischemia. The patient recovered uneventfully. Postoperatively, myocardial perfusion scintigraphy demonstrated no exercise-induced myocardial ischemia. Patients with ARCA who are asymptomatic and whose coronary course is not intramural can be managed without surgical intervention for an anomalous coronary artery.

著者

Yumi Matsushita Tetsuji Yokoyama Kayoko Hayakawa Nobuaki Matsunaga Hiroshi Ohtsu Sho Saito Mari Terada Setsuko Suzuki Shinichiro Morioka Satoshi Kutsuna Shinya Tsuzuki Hisao Hara Akio Kimura Norio Ohmagari

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220056, (Released:2022-07-16)

参考文献数

27

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Background: Prioritization for novel coronavirus disease 2019 (COVID-19)-related health policies usually considers age and certain other characteristics, but sex is rarely included, despite the higher risk of severe disease in men. The aim of this study was to compare the impact of sex and age on the severity of COVID-19 by estimating the age difference in years for which the risk for men versus women is the same.Methods: We analyzed 23,414 Japanese COVID-19 inpatients aged 20–89 years (13,360 men and 10,054 women). We graded the severity of COVID-19 (0 to 5) according to the most intensive treatment required during hospitalization. The risk of grade 2/3/4/5 (non-invasive positive pressure ventilation/invasive mechanical ventilation/extracorporeal membrane oxygenation/death), grade 3/4/5, and separately grade 5 was analyzed using a multiple logistic regression model.Results: The odds ratio (OR) of grades 2/3/4/5, 3/4/5 (primary outcome), and 5 for men relative to women was 2.76 (95% CI, 2.44–3.12), 2.78 (95% CI, 2.42–3.19), and 2.60 (95% CI, 2.23–3.03), respectively, after adjustment for age and date of admission. These risks for men were equivalent to those for women 14.1 (95% CI, 12.3–15.8), 11.2 (95% CI, 9.7–12.8), and 7.5 (95% CI, 6.3–8.7) years older, respectively.Conclusion: The risks of worse COVID-19 prognosis (grades 3/4/5) in men were equivalent to those of women 11.2 years older. Reanalyzing data extracted from four previous studies also revealed a large impact of sex difference on the severity of COVID-19. We should pay more attention to sex differences to predict the risk of COVID-19 severity and to formulate public health policy accordingly.

著者

Noriya MASAMURA Wakana OHASHI Nobuaki TSUGE Shinsuke IMAI Anri ISHII-NAKAMURA Hiroshi HIROTA Toshiyuki NAGATA Hidehiko KUMAGAI

出版者

Japan Society for Bioscience, Biotechnology, and Agrochemistry

雑誌

Bioscience, Biotechnology, and Biochemistry (ISSN:09168451)

巻号頁・発行日

vol.76, no.3, pp.447-453, 2012-03-23 (Released:2012-03-23)

参考文献数

31

被引用文献数

7

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Lachrymatory factor synthase (LFS), an enzyme essential for the synthesis of the onion lachrymatory factor (propanethial S-oxide), was identified in 2002. This was the first reported enzyme involved in the production of thioaldehyde S-oxides via an intra-molecular H+ substitution reaction, and we therefore attempted to identify the catalytic amino acid residues of LFS as the first step in elucidating the unique catalytic reaction mechanism of this enzyme. A comparison of the LFS cDNA sequences among lachrymatory Allium plants, a deletion analysis and site-directed mutagenesis enabled us to identify two amino acids (Arg71 and Glu88) that were indispensable to the LFS activity. Homology modeling was performed for LFS/23–169 on the basis of the template structure of a pyrabactin resistance 1-like protein (PYL) which had been selected from a BLASTP search on SWISS-MODEL against LFS/23–169. We identified in the modeled structure of LFS a pocket corresponding to the ligand-binding site in PYL, and Arg71 and Glu88 were located in this pocket.

著者

Masaki UJIHARA Masahito KOBAYASHI Hiroshi YAMAGUCHI Sachiko HIRATA Kazuhiko TAKABATAKE Kenji WAKIYA Atsushi SASAKI Takamitsu FUJIMAKI

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.9, pp.383-388, 2022-12-31 (Released:2022-11-09)

参考文献数

16

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We report an 18-year-old female patient who developed left temporal headache and fever one month after administration of isotretinoin for acne. Imaging studies demonstrated osteolytic change in the left frontal bone, and the lesion showed gadolinium contrast enhancement. Biopsy confirmed the diagnosis of osteomyelitis, and the symptoms improved after 8 months of medication with antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs). However, the pain recurred when isotretinoin was resumed. Isotretinoin sometimes causes excessive inflammation, which may have been the reason for the osteomyelitis in this case. Although osteomyelitis is usually caused by bacterial infection, a non-bacterial mechanism should also be suspected if the condition is resistant to antibiotics.

著者

Hidetoshi Inoue Kumiko Tajima Cristina Mitsumori Natsuko Inoue-Kashino Takamasa Miura Kentaro Ifuku Ryuichi Hirota Yasuhiro Kashino Katsutoshi Fujita Hiroshi Kinoshita

出版者

Applied Microbiology, Molecular and Cellular Biosciences Research Foundation

雑誌

The Journal of General and Applied Microbiology (ISSN:00221260)

巻号頁・発行日

vol.68, no.3, pp.151-162, 2022 (Released:2022-11-10)

参考文献数

36

被引用文献数

1

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A genetically modified (GM) strain of the diatom Chaetoceros gracilis expressing the phosphite dehydrogenase gene (ptxD), which is a useful gene both for the biological containment and the avoidance of microbial contamination, was characterized to estimate the risk against the biodiversity by laboratory experiments. GM strain could grow in the medium containing phosphite as a sole source of phosphorus, while its general characteristics such as growth, salt tolerance, heat and dehydration resistance in the normal phosphate-containing medium were equivalent to those of wild type (WT) strain. The increase in potential toxicity of GM strain against plant, crustacean, fish and mammal was also disproved. The dispersal ability of WT strain cultured in an outdoor raceway pond was investigated for 28 days by detecting the psb31 gene in vessels, settled at variable distances (between 5 and 60 m) from the pond. The diatom was detected only in one vessel placed 5 m apart. To estimate the influence on the environment, WT and GM strains were inoculated into freshwater, seawater and soil. The influence on the microbiome in those samples was assessed by 16S rRNA gene amplicon sequencing, in addition to the analysis of the survivability of those strains in the freshwater and the seawater. The results indicated that the effect to the microbiome and the survivability were comparable between WT and GM strains. All results showed that the introduction of the ptxD gene into the diatom had a low risk on biodiversity.

著者

庄司 博史 Hiroshi Shoji

出版者

大修館書店

雑誌

梶茂樹・中島由美・林徹編

巻号頁・発行日

pp.310-313, 2009-04-20

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事典世界のことば141

著者

Kentaro Kasa Hiroshi Hirukawa Shintaro Fukuda Fuyuki Asami Masatake Katsu Kazuo Yamamoto Shinpei Yoshi

出版者

The Editorial Committee of Annals of Vascular Diseases

雑誌

Annals of Vascular Diseases (ISSN:1881641X)

巻号頁・発行日

pp.cr.22-00031, (Released:2022-10-03)

参考文献数

9

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Secondary aortoenteric fistula (sAEF) is a rare but serious complication after open aortic aneurysm repair (OAR). Although there is no consensus on the treatment strategy for sAEF, acute management of bleeding and infection control greatly affect the outcome. We report five cases of sAEF following OAR from 2016 to 2021. One patient died of sepsis following graft infection, whereas the others had relatively good outcomes. No recurrence of infection or fistula has been observed over an average follow-up period of 29.8 months. Timely management of bleeding and infection with surgical intervention resulted in favorable outcomes in our patients.

著者

Satoshi Funayama Utaroh Motosugi Shintaro Ichikawa Hiroyuki Morisaka Yoshie Omiya Hiroshi Onishi

出版者

Japanese Society for Magnetic Resonance in Medicine

雑誌

Magnetic Resonance in Medical Sciences (ISSN:13473182)

巻号頁・発行日

pp.mp.2021-0103, (Released:2022-11-08)

参考文献数

47

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Purpose: To evaluate the feasibility of folded image training strategy (FITS) and the quality of images reconstructed using the improved model-based deep learning (iMoDL) network trained with FITS (FITS-iMoDL) for abdominal MR imaging.Methods: This retrospective study included abdominal 3D T1-weighted images of 122 patients. In the experimental analyses, peak SNR (PSNR) and structure similarity index (SSIM) of images reconstructed with FITS-iMoDL were compared with those with the following reconstruction methods: conventional model-based deep learning (conv-MoDL), MoDL trained with FITS (FITS-MoDL), total variation regularized compressed sensing (CS), and parallel imaging (CG-SENSE). In the clinical analysis, SNR and image contrast were measured on the reference, FITS-iMoDL, and CS images. Three radiologists evaluated the image quality using a 5-point scale to determine the mean opinion score (MOS).Results: The PSNR of FITS-iMoDL was significantly higher than that of FITS-MoDL, conv-MoDL, CS, and CG-SENSE (P < 0.001). The SSIM of FITS-iMoDL was significantly higher than those of the others (P < 0.001), except for FITS-MoDL (P = 0.056). In the clinical analysis, the SNR of FITS-iMoDL was significantly higher than that of the reference and CS (P < 0.0001). Image contrast was equivalent within an equivalence margin of 10% among these three image sets (P < 0.0001). MOS was significantly improved in FITS-iMoDL (P < 0.001) compared with CS images in terms of liver edge and vessels conspicuity, lesion depiction, artifacts, blurring, and overall image quality.Conclusion: The proposed method, FITS-iMoDL, allowed a deeper MoDL reconstruction network without increasing memory consumption and improved image quality on abdominal 3D T1-weighted imaging compared with CS images.

著者

三木 康明 楠田 寛 上西 裕之 魚橋 武司 堺 俊明 Yasuaki Miki Hiroshi Kusuda Hiroyuki Uenishi Takeshi Uohashi Toshiaki Sakai 魚橋病院 魚橋病院 魚橋病院 魚橋病院 魚橋病院 Uohashi Hospital Uohashi Hospital Uohashi Hospital Uohashi Hospital Uohashi Hospital

雑誌

藍野学院紀要 = Bulletin of Aino Gakuin (ISSN:09186263)

巻号頁・発行日

vol.21, 2008-03-31

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本研究では,男女が合同して作業療法を行なうことにより,患者がどのような影響をうけるかを検討した。開始直前と開始後3ヶ月後に,PANSSとRRSを用いて,評価したところ,「社会参加の広がり」,「外見への配慮」に関する項目では,女性に顕著な結果が現れた。このような変化は男女合同プログラム実施によって,社会性の獲得に影響を与えることが示唆された。この様な変化の理由としては,男女合同プログラム開始以前の女性患者は病棟外での活動が少なかったため,男性より外部刺激に曝されることが少なかったことが大きな理由であると考えられた。また,プログラム実施において女性の参加率の偏りが見られた。これについては(1)男性への拒否感,(2)参加の場所(男性病棟)が原因と考えられた。これらを改善することと,ストレスへの耐性を高める関わりが必要と考えられた。

著者

Yuko Maki Hiroshi Soejima Tamizi Sugiyama Takeo Sato Junji Yamaguchi Masaaki K. Watahiki

出版者

Japanese Society for Plant Biotechnology

雑誌

Plant Biotechnology (ISSN:13424580)

巻号頁・発行日

vol.39, no.2, pp.173-177, 2022-06-25 (Released:2022-06-25)

参考文献数

23

被引用文献数

3

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3-Phenyllactic acid (PLA) is a common secondary product of Lactobacillus sp. and promotes adventitious-root formation in Azuki beans (Vigna angularis). Root promotion activity of PLA is synergistically enhanced by tryptophan (Trp). In this study, stereoisomers of PLA and Trp amide conjugates and their alkyl esters were synthesized to investigate the structure–activity relationships on root-promotion activity. The rooting activity of D-PLA-L-Trp conjugate shows more than 40 times higher than that of the mixture of D-PLA and L-Trp. Modification of PLA-Trp with ethyl ester showed the highest activity at 3,400 times of a mixture of D-PLA and L-Trp. However, L-or D-PLA-D-Trp conjugate and the isopropyl ester of PLA-Trp conjugates, both lost the root promotion activity and implicated that a requirement for steric structure for PLA related root promotion mechanism. Unlike auxin substances, which are commonly used as rooting agents that displayed high activity in low concentrations, PLA-Trp ethyl ester exhibited far less phytotoxicity at high concentration of 1 mM, despite its high rooting activity. Innovation of PLA-Trp ethyl ester may be expected for agricultural aspects with low environmental impact.

著者

Yuko Maki Hiroshi Soejima Tamizi Sugiyama Masaaki K. Watahiki Takeo Sato Junji Yamaguchi

出版者

Japanese Society for Plant Biotechnology

雑誌

Plant Biotechnology (ISSN:13424580)

巻号頁・発行日

vol.39, no.2, pp.111-117, 2022-06-25 (Released:2022-06-25)

参考文献数

36

被引用文献数

2

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Many microorganisms have been reported to produce compounds that promote plant growth and are thought to be involved in the establishment and maintenance of symbiotic relationships. 3-Phenyllactic acid (PLA) produced by lactic acid bacteria was previously shown to promote root growth in adzuki cuttings. However, the mode of action of PLA as a root-promoting substance had not been clarified. The present study therefore investigated the relationship between PLA and auxin. PLA was found to inhibit primary root elongation and to increase lateral root density in wild-type Arabidopsis, but not in an auxin signaling mutant. In addition, PLA induced IAA19 promoter fused β-glucuronidase gene expression, suggesting that PLA exhibits auxin-like activity. The inability of PLA to promote degradation of Auxin/Indole-3-Acetic Acid protein in a yeast heterologous reconstitution system indicated that PLA may not a ligand of auxin receptor. Using of a synthetic PLA labeled with stable isotope showed that exogenously applied PLA was converted to phenylacetic acid (PAA), an endogenous auxin, in both adzuki and Arabidopsis. Taken together, these results suggest that exogenous PLA promotes auxin signaling by conversion to PAA, thereby regulating root growth in plants.

著者

Junichirou Ohzeki Kazuto Kugou Koichiro Otake Koei Okazaki Seiji Takahashi Daisuke Shibata Hiroshi Masumoto

出版者

Japanese Society for Plant Biotechnology

雑誌

Plant Biotechnology (ISSN:13424580)

巻号頁・発行日

vol.39, no.2, pp.101-110, 2022-06-25 (Released:2022-06-25)

参考文献数

55

被引用文献数

2

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Genome information has been accumulated for many species, and these genes and regulatory sequences are expected to be applied in plants by enhancing or creating new metabolic pathways. We hypothesized that manipulating a long array of repetitive sequences using tethered chromatin modulators would be effective for robust regulation of gene expression in close proximity to the arrays. This approach is based on a human artificial chromosome made of long synthetic repetitive DNA sequences in which we manipulated the chromatin by tethering the modifiers. However, a method for introducing long repetitive DNA sequences into plants has not yet been established. Therefore, we constructed a bacterial artificial chromosome-based binary vector in Escherichia coli cells to generate a construct in which a cassette of marker genes was inserted into 60-kb synthetic human centromeric repetitive DNA. The binary vector was then transferred to Agrobacterium cells and its stable maintenance confirmed. Next, using Agrobacterium-mediated genetic transformation, this construct was successfully introduced into the genome of cultured tobacco BY-2 cells to obtain a large number of stable one-copy strains. ChIP analysis of obtained BY-2 cell lines revealed that the introduced synthetic repetitive DNA has moderate chromatin modification levels with lower heterochromatin (H3K9me2) or euchromatin (H3K4me3) modifications compared to the host centromeric repetitive DNA or an active Tub6 gene, respectively. Such a synthetic DNA sequence with moderate chromatin modification levels is expected to facilitate manipulation of the chromatin structure to either open or closed.

著者

Hiroshi Ueno

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.86, no.11, pp.1745-1747, 2022-10-25 (Released:2022-10-25)

参考文献数

12

著者

Yoichi Takaya Teiji Akagi Hidehiko Hara Hideaki Kanazawa Yuji Ikari Akihiro Isotani Shinichi Shirai Shunsuke Kubo Takao Morikawa Toru Naganuma Mike Saji Shingo Kuwata Go Hiasa Yusuke Watanabe Masahiro Yamawaki Masao Imai Takashi Matsumoto Masanori Yamamoto Tsutomu Murakami Masahiko Asami Isamu Mizote Tsukasa Okai Hiroki Bota Hiroshi Ito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0048, (Released:2022-04-05)

参考文献数

18

被引用文献数

4

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Background: Transcatheter mitral valve repair with the MitraClip system has been established in selected high-risk patients. The MitraClip procedure results in a relatively large iatrogenic atrial septal defect (iASD). This study aimed to investigate the prevalence and clinical course of iASD requiring transcatheter closure following the MitraClip procedure.Methods and Results: This study was conducted at all 59 institutions that perform transcatheter mitral valve repair with the MitraClip system in Japan. The data of patients on whom transcatheter iASD closure was performed were collected. Of the 2,722 patients who underwent the MitraClip procedure, 30 (1%) required transcatheter iASD closure. The maximum iASD size was 9±4 mm (range, 3–18 mm). The common clinical course of transcatheter iASD closure was hypoxemia with right-to-left shunt or right-sided heart failure with left-to-right shunt. Of the 30 patients, 22 (73%) required transcatheter closure within 24 h following the MitraClip procedure, including 12 with hypoxemia and 5 with right-sided heart failure complicated with cardiogenic shock. Of the 5 patients, 2 required mechanical circulatory support devices. Twenty-one patients immediately underwent transcatheter iASD closure, and hemodynamic deteriorations were resolved; however, 1 patient died without having undergone transcatheter closure.Conclusions: Transcatheter iASD closure was required in 1% of patients who underwent the MitraClip procedure. Many of these patients immediately underwent transcatheter iASD closure because of hypoxemia with right-to-left shunt or right-sided heart failure with left-to-right shunt.

著者

Kensaku Nishihira Nehiro Kuriyama Kosuke Kadooka Yasuhiro Honda Keisuke Yamamoto Shun Nishino Suguru Ebihara Kenji Ogata Toshiyuki Kimura Hiroshi Koiwaya Yoshisato Shibata

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.4, no.10, pp.474-481, 2022-10-07 (Released:2022-10-07)

参考文献数

30

被引用文献数

1

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Background: As life expectancy rises, percutaneous coronary intervention (PCI) is being performed more frequently, even in elderly patients with acute myocardial infarction (AMI). This study evaluated outcomes of elderly patients with AMI complicated by heart failure (AMIHF), as defined by Killip Class ≥2 at admission, who undergo PCI.Methods and Results: We retrospectively analyzed 185 patients with AMIHF aged ≥80 years (median age 85 years) who underwent PCI between 2009 and 2019. The median follow-up period was 572 days. The rates of in-hospital major bleeding (Bleeding Academic Research Consortium Type 3 or 5) and in-hospital all-cause mortality were 20.5% and 25.9%, respectively. The proportion of frail patients increased during hospitalization, from 40.6% at admission to 59.2% at discharge (P<0.01). The cumulative incidence of all-cause mortality was 36.3% at 1 year and 44.1% at 2 years. After adjusting for confounders, advanced age, Killip Class 4, final Thrombolysis in Myocardial Infarction flow grade <3, and longer door-to-balloon time were associated with higher mortality, whereas higher left ventricular ejection fraction and cardiac rehabilitation were associated with lower mortality (all P<0.05). Progression of frailty during hospitalization was an independent risk factor for long-term mortality in hospital survivors (P<0.01).Conclusions: The management of patients with AMIHF aged ≥80 years who undergo PCI remains challenging, with high rates of in-hospital major bleeding, frailty progression, and mortality.