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  • Ovid Technologies (Wolters Kluwer Health)  (43)
  • 1
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    Cardiovascular Risk With and Without Antihypertensive Drug Treatment in the Japanese General Population : Participant-Level Meta-Analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Hypertension Vol. 63, No. 6 ( 2014-06), p. 1189-1197
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 63, No. 6 ( 2014-06), p. 1189-1197
    Abstract: To evaluate the cardiovascular mortality risk in association with blood pressure level among people with and without antihypertensive treatment, we performed the participant-level meta-analysis that included 39 705 Japanese from 6 cohorts (58.4% women; mean age, 60.1 years; 20.4% treated). Multivariable-adjusted Cox models were used to analyze the risk of cardiovascular mortality and its subtypes among 6 blood pressure levels according to recent guidelines, optimal to Grade 3 hypertension, and the usage of antihypertensive medication at baseline. During median 10.0 years of follow-up, there were 2032 cardiovascular deaths (5.1 per 1000 person-years), of which 410 deaths were coronary heart disease, 371 were heart failure, and 903 deaths were stroke. Treated participants had significantly higher risk for cardiovascular mortality (hazard ratios, 1.50; 95% confidence intervals, 1.36–1.66), coronary heart disease (hazard ratios, 1.53; confidence intervals, 1.23–1.90), heart failure (hazard ratios, 1.39; confidence intervals, 1.09–1.76), and stroke (hazard ratios, 1.48; confidence intervals, 1.28–1.72) compared with untreated people. Among untreated participants, the risks increased linearly with an increment of blood pressure category ( P ≤0.011). The risk increments per blood pressure category were higher in young participants ( 〈 60 years; 22% to 79%) than those in old people (≥60 years; 7% to 15%) with significant interaction for total cardiovascular, heart failure, and stroke mortality ( P ≤0.026). Among treated participants, the significant linear association was also observed for cardiovascular mortality ( P =0.0003), whereas no stepwise increase in stroke death was observed ( P =0.19). The risks of cardiovascular mortality were ≈1.5-fold high in participants under antihypertensive medication. More attention should be paid to the residual cardiovascular risks in treated patients.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.113.03206
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
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  • 2
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    Abstract 12824: Comparison of Tissue Doppler-Derived and Speckle Tracking-Derived Parameters for the Estimation of Left Ventricular Filling Pressure: A Multicenter Study in Japan
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 130, No. suppl_2 ( 2014-11-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Abstract: Background: We conducted a multicenter study in Japan to compare tissue Doppler echocardiography-derived and speckle tracking echocardiography (STE)-derived parameters of left ventricular (LV) diastolic function for the estimation of LV filling pressure. Methods: Seventy-eight patients (age 59±14 years, 59 male) with structural heart diseases including angina pectoris (n=34), old myocardial infarction (n=15), dilated cardiomyopathy (n=13), hypertrophic cardiomyopathy (n=8), and hypertensive heart disease (n=8) were studied according to the same protocol in 5 university hospitals in Japan. LV mean diastolic pressure (MDP) was measured by using a micromanometer-tipped catheter. Early-diastolic mitral annular velocity (e′) was measured at septal and lateral side of the annulus and averaged, and the ratio of early-diastolic transmitral velocity to e′ (E/e′) was calculated. Global longitudinal strain was measured using STE in 3 apical views and averaged on a frame-by-frame basis to construct a time-strain curve as well as a time-strain rate (SR) curve. Then, the absolute value of peak longitudinal strain (LS), early-diastolic peak SR (LSR E ), and that during isovolumic relaxation (IVR) period (LSR IVR ) were measured. Similarly, peak circumferential strain (CS), early-diastolic peak circumferential SR (CSR E ), and that during IVR (CSR IVR ) were measured from 3 short-axis views. Results: E/e′ weakly correlated with MDP (r=0.50, p 〈 0.001). E/LSR IVR and E/CSR IVR did not correlate with MDP, whereas there was a significant but weak correlation between E/LSR E and MDP (r=0.50, p 〈 0.001) or between E/CSR E and MDP (r=0.41, p 〈 0.001). In contrast, there was a good correlation between E/LS and MDP (r=0.70, p 〈 0.001) or between E/CS and MDP (r=0.62, p 〈 0.001). Especially, the correlation between E/LS and MDP was statistically better than that between E/e′ and MDP (p 〈 0.01). Conclusions: STE-derived longitudinal parameters better correlated with MDP than circumferential parameters. Especially, E/LS was better than E/e′ for estimating LV filling pressure.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.130.suppl_2.12824
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
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  • 3
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    Serial Imaging Changes During Treatment of Immunoglobulin G4–Related Disease With Multiple Pseudotumors
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 131, No. 21 ( 2015-05-26), p. 1882-1883
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 131, No. 21 ( 2015-05-26), p. 1882-1883
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/CIRCULATIONAHA.115.015638
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 4
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    Abstract 13145: Differences of Cancer Types in Hospital Mortality in Patients With Venous Thromboembolism
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_3 ( 2020-11-17)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
    Abstract: Introduction: We sought to evaluate the clinical characteristics and outcomes of patients with cancer-associated VTE, compared with the matched cohort without cancer using real-world big data of VTE. Background: Cancer is associated with a high incidence of Venous Thromboembolism (VTE) and there are many guidelines/recommendations about VTE. However, the prognosis of cancer-VTE patients is not well known because of a lack of big data. Moreover, there is also no knowledge on how cancer type is related to prognosis. Methods: This study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Datasets (JROAD-DPC). We identified 28,247 patients who were first hospitalized with VTE from April 2012 to March 2017. 26.0% were cancer patients. Compared with national statistics of cancer incidence in 2015 from National Cancer Center of Japan, the proportion of gynecological cancer patients was higher, but other cancer types had similar prevalence rates. Propensity score (PS) was estimated with logistic regression model, with cancer as the dependent variable and 18 clinically relevant covariates. Results: We included 24,576 patients after exclusion. The median age was 71years (range: 59-80 years), and 42.0% were male. On PS-matched analysis with 12,418 patients, patients with cancer had higher total in-hospital mortality (9.5% vs. 3.8%, P 〈 0.001; OR, 2.72, 95% CI: 2.33-3.19) and in-hospital mortality within 30days (6.8% vs. 3.2%, P 〈 0.001; OR, 2.20, 95% CI: 1.85-2.62). On analysis for each type of cancer, in-hospital mortality in 10 types of cancer was significantly high, especially pancreas (OR: 9.65, 95%CI: 4.31-21.64), biliary tract (OR: 8.36, 95%CI: 2.42-28.89) and liver (OR: 7.33, 95%CI: 1.92-28.02). Conclusions: Patients with cancer had a higher in-hospital mortality for VTE than those without cancer, especially in pancreatic, biliary tract and liver cancers.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.142.suppl_3.13145
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 5
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    Abstract 13607: Differential Response of Local Coagulation after Implantation of New Generation Drug-Eluting Stents Compared with Sirolimus-Eluting Stent
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 130, No. suppl_2 ( 2014-11-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Abstract: Purpose: We have previously demonstrated local persistent hypercoagulation after sirolimus-eluting stent (SES) implantation by measuring plasma prothrombin fragment F1+2(frF1+2) levels. The aim of this study is to examine local coagulation response after biolimus-eluting stent (BES) and everolimus-eluting stent (EES) implantation. Methods: Sixty-eight patients who were treated with stents about eight months earlier to the mid-segment of the left anterior descending coronary artery, with no evidence of restenosis, were studied (BES: 12pts, EES: 15pts, SES: 23pts, and BMS: 18pts). We measured plasma levels of frF1+2 sampled in coronary sinus (CS) and sinus of Valsalva (V). The transcardiac frF1+2 gradients (ΔfrF1+2) were defined as CS level minus V level. The patients were divided into 2 groups according to total stent length [longer stent group (≥24mm) or shorter stent group ( 〈 24mm)]. Results: A larger percent diameter stenosis was observed in the BMS group than in the SES, EES, and BES groups (25.1±15.6 vs 7.1±16.5, 12.5±12.8, 10.3±14.2%, p 〈 0.05, respectively). The ΔfrF1+2 was greater in the SES group than in the BMS, EES, and BES groups, and no significant differences were observed among the BMS, EES, and BES groups (23.4±21.1 vs 4.7±13.4, 3.2±11.7, 1.5±11.1 pmol/l, p 〈 0.05, respectively). The ΔfrF1+2 in longer stent group (n=11) was significantly greater than in shorter stent group (n=12) (27.4±12.1 vs 19.2±10.1 pmol/l, p 〈 0.05) only in the SES group, however, no significant differences were observed according to total stent length in other groups. Conclusions: A lower response of local coagulation after BES and EES implantation was shown, and significant correlation between local hypercoagulation and total stent length was observed only after SES implantation. These findings might be associated with lower strut thickness and unique characteristics of polymer in second-generation drug-eluting stents.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.130.suppl_2.13607
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
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  • 6
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    Abstract 19088: Atrial Late Potentials and Atrial Substrate Remodeling in Patients With Atrial Fibrillation
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 132, No. suppl_3 ( 2015-11-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
    Abstract: Backgrounds: Patients with atrial fibrillation (AF) often have a low-amplitude potential in the terminal part of filtered P-wave (atrial late potential: aLP). However, it remains unknown what aLP reflects in AF patients. On the other hand, electrical remodeling of the atria can be precisely evaluated by the quantitative voltage map analysis using 3D mapping system. In this study, we hypothesized that we could substitute "non-invasive" aLP for "invasive" 3D mapping system to evaluate the atrial electrical remodeling and investigated the relationship between aLP and atrial substrate remodeling in AF patients. Methods: The P-wave single-averaged electrocardiogram (P-SAECG) was recored in 60 patients with paroxysmal AF who underwent PV isolation. Filtered P-wave duration (fPWD) and root-mean-squared voltage of the terminal 20ms of ≤2.0 μV (RMS20) were assessed by P-SAECG. The left atrial (LA) global contact mapping during sinus rhythm was performed and LA voltage zone index (LAVZI) was defined as an area with voltage 〈 0.5mV divided by total LA surface area. Results: LAVZI showed a strong positive correlation with fPWD and a strong negative correlation with RMS20 (r=-0.82, p 〈 0.01; r=0.68, p 〈 0.01, respectively). LV volume by echocardiography was also positively correlated with fPWD and negatively correlated with RMS20 (r=0.57, p 〈 0.05; r=-0.69, p 〈 0.01, respectively). In addition, LA appendage flow was negatively correlated with fPWD (r=-0.49, p 〈 0.05). fPWD was significantly longer and RMS20 was lower in patients with AF for more than 1 year than those for less than 1 year. However, there were no significant correlations between aLP parameters and other echocardiographic findings such as left ventricular ejection fraction or plasma BNP concentration. Conclusions: aLP reflects precisely atrial substrate remodeling in AF patients. aLP might serve as non-invasive tool for monitoring the atrial substrate remodeling in patients with AF.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.132.suppl_3.19088
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 7
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    Abstract 13157: Deep Learning for Detection of Elevated Pulmonary Artery Wedge Pressure Using Standard Chest X-ray
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_3 ( 2020-11-17)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
    Abstract: Introduction: Chest X-ray (CXR) is a useful and economical modality for the detection of congestive heart failure. However, the accuracy is limited by the subjective nature of its interpretation. Deep learning (DL) can be used to recognize diseases or findings objectively in various imaging modalities, and may outperform previous diagnostic techniques. Hypothesis: We hypothesized that DL-based analysis of CXR detect the presence of elevated pulmonary arterial wedge pressure (PAWP) in patients with suspected heart failure. Methods: We enrolled 1,013 patients with paired right heart catheterization and CXR performed from October 2009 to February 2020 in our hospital. DL algorithm for the detection of elevated PAWP was developed using the training dataset, based on a single CXR image. Independent evaluation cohort of 115 patients was performed using CXR-based DL model and echocardiographic data to detect the presence of high PAWP. The area under the receiver operating characteristic curve (AUC) was used to evaluate the performance of the DL-based models compared with echocardiographic data. Results: The study included 1,013 patients (mean age, 67±13 years; 569 males [56%]). The mean PAWP was 12.5±6.4 mmHg and 218 patients (22%) had more than 18mmHg. To detect high PAWP, the AUC produced by DL algorithms was effective, and the DL algorithm with the largest AUC was ResNet50. In an evaluation cohort, to detect high PAWP, the AUC using the DL model with CXR was similar to the AUC produced by the echocardiographic left ventricular diastolic dysfunction algorithm (0.77 vs. 0.70; respectively; p=0.27), and significantly higher than the AUC by measurements of echocardiographic parameters (ResNet50 vs. other parameters; all compared p 〈 0.05) (Figure) . Conclusions: The present results demonstrated that DL based on analysis of CXR can detect the presence of high PAWP. This finding suggests that the DL based approach may support an objective evaluation of CXR in the clinical setting.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.142.suppl_3.13157
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 8
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    Sex Differences in Blood Pressure and Potential Implications for Cardiovascular Risk Management
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Hypertension Vol. 80, No. 2 ( 2023-02), p. 316-324
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 80, No. 2 ( 2023-02), p. 316-324
    Abstract: Accurate blood pressure (BP) measurement is critical for optimal cardiovascular risk management. Age-related trajectories for cuff-measured BP accelerate faster in women compared with men, but whether cuff BP represents the intraarterial (invasive) aortic BP is unknown. This study aimed to determine the sex differences between cuff BP, invasive aortic BP, and the difference between the 2 measurements. Methods: Upper-arm cuff BP and invasive aortic BP were measured during coronary angiography in 1615 subjects from the Invasive Blood Pressure Consortium Database. This analysis comprised 22 different cuff BP devices from 28 studies. Results: Subjects were 64±11 years (range 40–89) and 32% women. For the same cuff systolic BP (SBP), invasive aortic SBP was 4.4 mm Hg higher in women compared with men. Cuff and invasive aortic SBP were higher in women compared with men, but the sex difference was more pronounced from invasive aortic SBP, was the lowest in younger ages, and the highest in older ages. Cuff diastolic blood pressure overestimated invasive diastolic blood pressure in both sexes. For cuff and invasive diastolic blood pressure separately, there were sex*age interactions in which diastolic blood pressure was higher in younger men and lower in older men, compared with women. Cuff pulse pressure underestimated invasive aortic pulse pressure in excess of 10 mm Hg for both sexes in older age. Conclusions: For the same cuff SBP, invasive aortic SBP was higher in women compared with men. How this translates to cardiovascular risk prediction needs to be determined, but women may be at higher BP-related risk than estimated by cuff measurements.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.122.19693
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2094210-2
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  • 9
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    Assessment of the Risk Factors for Colonic Diverticular Hemorrhage
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Diseases of the Colon & Rectum Vol. 51, No. 1 ( 2008-01), p. 116-120
    Details
    In: Diseases of the Colon & Rectum, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. 1 ( 2008-01), p. 116-120
    Type of Medium: Online Resource
    ISSN: 0012-3706
    URL: Article
    DOI: 10.1007/s10350-007-9137-8
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
    detail.hit.zdb_id: 2046914-7
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  • 10
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    Impact of Blood Pressure Visit‐to‐Visit Variability on Adverse Events in Patients With Nonvalvular Atrial Fibrillation: Subanalysis of the J‐RHYTHM Registry
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Journal of the American Heart Association Vol. 10, No. 1 ( 2021-01-05)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 1 ( 2021-01-05)
    Abstract: Blood pressure (BP) variability has reportedly been a risk factor for various clinical events. To clarify the influence of BP visit‐to‐visit variability on adverse events in patients with nonvalvular atrial fibrillation, a post hoc analysis of the J‐RHYTHM Registry was performed. Methods and Results Of 7406 outpatients with nonvalvular atrial fibrillation from 158 institutions, 7226 (age, 69.7±9.9 years; men, 70.7%), in whom BP was measured 4 times or more (14.6±5.0 times) during the 2‐year follow‐up period or until occurrence of an event, constituted the study group. SD and coefficient of variation of BP values were calculated as BP variability. Thromboembolism, major hemorrhage, and all‐cause death occurred in 110 (1.5%), 121 (1.7%), and 168 (2.3%) patients, respectively. When patients were divided into quartiles of systolic BP‐SD ( 〈 8.20, 8.20–10.49, 10.50–13.19, and ≥13.20 mm Hg), hazard ratios (HRs) for all adverse events were significantly high in the highest quartile compared with the lowest quartile (HR, 2.00, 95% CI, 1.15–3.49, P =0.015 for thromboembolism; HR, 2.60, 95% CI, 1.36–4.97, P =0.004 for major hemorrhage; and HR, 1.85, 95% CI, 1.11–3.07, P =0.018 for all‐cause death) after adjusting for components of the CHA 2 DS 2 ‐VASc score, warfarin and antiplatelet use, atrial fibrillation type, BP measurement times, and others. These findings were consistent when BP‐coefficient of variation was used instead of BP‐SD. Conclusions Systolic BP visit‐to‐visit variability was significantly associated with all adverse events in patients with nonvalvular atrial fibrillation. Further studies are needed to clarify the causality between BP variability and adverse outcomes in patients with nonvalvular atrial fibrillation. Registration URL: https://www.umin.ac.jp/ctr/ ; Unique Identifier: UMIN000001569.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.120.018585
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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