Fujita Medical Journal最新文献_第3页

Assessing protein and albumin recovery rates in different ascites filtration membrane washing methods for cell-free and concentrated ascites reinfusion therapy. 评估无细胞和浓缩腹水再灌注疗法中不同腹水滤膜洗涤方法的蛋白质和白蛋白回收率。

Fujita Medical Journal Pub Date : 2024-05-01 Epub Date: 2024-02-15 DOI: 10.20407/fmj.2023-005

Sachie Yamada, Norio Nii, Atsushi Ohashi, Midori Hasegawa, Yukio Yuzawa, Naotake Tsuboi

{"title":"Assessing protein and albumin recovery rates in different ascites filtration membrane washing methods for cell-free and concentrated ascites reinfusion therapy.","authors":"Sachie Yamada, Norio Nii, Atsushi Ohashi, Midori Hasegawa, Yukio Yuzawa, Naotake Tsuboi","doi":"10.20407/fmj.2023-005","DOIUrl":"https://doi.org/10.20407/fmj.2023-005","url":null,"abstract":"Objectives: In cell-free and concentrated ascites reinfusion therapy (CART), the protein recovery rate decreases when the filtration membrane gets clogged. Employing a device with a filtration membrane washing feature prevents clogging, but it leads to the loss of ascites within the filter, resulting in reduced protein recovery. This study employed a device with a membrane washing function to investigate the relationship between protein recovery rate and the quantity of washing solution used, depending on the selected washing method.Methods: We analyzed cases of CART conducted at Fujita Health University Hospital between May 2021 and November 2022. The cases were divided and compared between two groups: one using flush and rinse as the washing method (flush+rinse group) and another using only flushing (flush group).Results: We identified nine cases and 16 sessions. In the flush+rinse group, the median amount of washing solution used per membrane washing was 259 mL per cycle, whereas it was 54 mL per cycle in the flush group. This difference was statistically significant (p<0.0001). The median total protein recovery rate was 53.8% for the flush+rinse group and 78.8% for the flush group, with the latter showing a significantly higher value (p=0.0199).Conclusions: In CART using a membrane washing function, adopting a washing method that reduces the amount of washing solution leads to an increase in the total protein recovery rate.","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"10 2","pages":"53-59"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11063573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Life and Science of Professor Tsuneko Okazaki, and her time at Fujita Health University. 冈崎纲子教授的生活与科学，以及她在藤田保健大学的时光。

Fujita Medical Journal Pub Date : 2024-02-01 Epub Date: 2023-11-29 DOI: 10.20407/fmj.2023-014

Johannes M Dijkstra, Toshiharu Nagatsu

引用次数: 0

Comparison between optical coherence tomography-guided and intravascular ultrasound-guided primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. 光学相干断层扫描引导下与血管内超声引导下经皮冠状动脉介入治疗 ST 段抬高型心肌梗死的比较。

Fujita Medical Journal Pub Date : 2024-02-01 Epub Date: 2023-11-29 DOI: 10.20407/fmj.2023-006

Yuji Matsuwaki, Takashi Muramatsu, Yukio Ozaki, Takashi Uwatoko, Takuo Toriya, Hidemaro Takatsu, Yu Yoshiki, Masataka Yoshinaga, Masato Ishikawa, Masaya Ohota, Hideaki Ota, Hideo Izawa

{"title":"Comparison between optical coherence tomography-guided and intravascular ultrasound-guided primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.","authors":"Yuji Matsuwaki, Takashi Muramatsu, Yukio Ozaki, Takashi Uwatoko, Takuo Toriya, Hidemaro Takatsu, Yu Yoshiki, Masataka Yoshinaga, Masato Ishikawa, Masaya Ohota, Hideaki Ota, Hideo Izawa","doi":"10.20407/fmj.2023-006","DOIUrl":"10.20407/fmj.2023-006","url":null,"abstract":"Objective: To examine the clinical outcomes of optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) in patients presenting with ST-segment elevation myocardial infarction (STEMI).Methods: We retrospectively investigated 533 consecutive patients who underwent primary PCI for STEMI between June 2016 and December 2020. The primary endpoint was a target lesion failure (TLF; defined as a composite of cardiac death, target vessel myocardial infarction, or target lesion revascularization). Propensity score (PS) matching was performed to allow direct comparison of OCT-guided and intravascular ultrasound (IVUS)-guided PCI.Results: Patients in the OCT group (n=166) were younger than those in the IVUS group (n=367) and had a significantly higher left ventricular ejection fraction and estimated glomerular filtration rate. Killip class IV and left main stem disease were more common in the IVUS group. The median peak creatine kinase level was comparable between the two groups (1953 U/L vs 1603 U/L). A significantly larger amount of contrast was used in the OCT group (200 mL vs 165 mL; p<0.001). The cumulative incidence of TLF during a median follow-up of 2.2 years did not differ significantly between OCT and IVUS groups (9.6% vs 13.6%; p=0.221) but cardiac mortality was significantly higher in the IVUS group (8.7% vs 3.6%; p=0.047). After PS matching (n=161 in each group), there was no significant between-group difference in TLF or any other clinical outcome measures.Conclusions: OCT-guided PCI demonstrated clinical outcomes in patients with STEMI that were comparable to those of IVUS-guided PCI despite considerable differences in background characteristics.","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"10 1","pages":"16-23"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10847631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Functional outcomes of protocol-based rehabilitation for patients with coronavirus disease 2019 in an acute care setting. 2019年急症护理环境中冠状病毒疾病患者基于方案的康复训练的功能结果。

Fujita Medical Journal Pub Date : 2024-02-01 Epub Date: 2023-11-29 DOI: 10.20407/fmj.2023-015

Yoshitaka Wada, Seiko Shibata, Ayato Shinohara, Koji Mizutani, Masahiko Mukaino, Yohei Otaka

{"title":"Functional outcomes of protocol-based rehabilitation for patients with coronavirus disease 2019 in an acute care setting.","authors":"Yoshitaka Wada, Seiko Shibata, Ayato Shinohara, Koji Mizutani, Masahiko Mukaino, Yohei Otaka","doi":"10.20407/fmj.2023-015","DOIUrl":"10.20407/fmj.2023-015","url":null,"abstract":"Objectives: To examine the functional outcomes of patients with coronavirus disease 2019 (COVID-19) who underwent a new protocol-based rehabilitation program.Methods: In this retrospective cohort study, we enrolled patients who were hospitalised in a university hospital in Japan because of COVID-19 from 1st September, 2020-5th July, 2021. The primary outcome was the Functional Independence Measure (FIM) subtotal score for motor items at discharge. The secondary outcomes included the FIM cognitive subtotal score, length of hospital stay, rehabilitation period, total rehabilitation time, final rehabilitation protocol level, and discharge destination.Results: Of the 78 enrolled patients (49 men; mean age [standard deviation], 70.3 [13.9] years), 24 died (30.8%) during hospitalisation. Disease severity was classified as mild, moderate I, moderate II, and severe in 1, 6, 41, and 30 patients, respectively. The FIM motor subtotal score differed significantly among groups for all participants (p=0.027). Post hoc analysis revealed that the FIM motor subtotal score in the severe group was significantly lower than that in the moderate II group (p=0.030).Conclusions: Disease severity significantly affected patients' functional outcome for COVID-19 at discharge. Our protocol-based program provides a benchmark for COVID-19 rehabilitation in an acute care setting.","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"10 1","pages":"35-42"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10847633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prediction of early falls using adherence and balance assessments in a convalescent rehabilitation ward. 利用疗养康复病房中的依从性和平衡评估预测早期跌倒。

Fujita Medical Journal Pub Date : 2024-02-01 Epub Date: 2023-11-29 DOI: 10.20407/fmj.2022-037

Toshio Teranishi, Megumi Suzuki, Masayuki Yamada, Akiko Maeda, Motomi Yokota, Naoki Itoh, Masanori Tanimoto, Aiko Osawa, Izumi Kondo

{"title":"Prediction of early falls using adherence and balance assessments in a convalescent rehabilitation ward.","authors":"Toshio Teranishi, Megumi Suzuki, Masayuki Yamada, Akiko Maeda, Motomi Yokota, Naoki Itoh, Masanori Tanimoto, Aiko Osawa, Izumi Kondo","doi":"10.20407/fmj.2022-037","DOIUrl":"10.20407/fmj.2022-037","url":null,"abstract":"Objectives: To predict falls by adding an adherence assessment to a static balance ability assessment, and to evaluate fall prediction accuracy.Methods: This study included 416 patients who were admitted to a 45-bed convalescent rehabilitation ward over a 2-year period. The patients were assessed at the time of admission using the Standing Test for Imbalance and Disequilibrium (SIDE) and three additional, newly developed adherence items. Patients were divided into two groups: a group that experienced falls (fall group) and a group that did not experience falls (non-fall group) within 14 days of admission. The sensitivity and specificity of the assessment items for predicting falls were calculated.Results: Sensitivity was 0.86 and specificity was 0.42 when the cutoff was between SIDE levels 0-2a and 2b-4. Combining balance assessment using the SIDE with the memory and instruction adherence items improved fall prediction accuracy such that the sensitivity was 0.75 and the specificity was 0.64.Conclusions: Our analysis suggested that adherence assessment can improve fall risk prediction accuracy.","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"10 1","pages":"30-34"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10847636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Taxonomic classification of genus Aeromonas using open reading frame-based binarized structure network analysis. 利用基于开放阅读框的二值化结构网络分析对气单胞菌属进行分类。

Fujita Medical Journal Pub Date : 2024-02-01 Epub Date: 2023-11-29 DOI: 10.20407/fmj.2023-007

Aki Sakurai, Masahiro Suzuki, Kengo Hayashi, Yohei Doi

{"title":"Taxonomic classification of genus Aeromonas using open reading frame-based binarized structure network analysis.","authors":"Aki Sakurai, Masahiro Suzuki, Kengo Hayashi, Yohei Doi","doi":"10.20407/fmj.2023-007","DOIUrl":"10.20407/fmj.2023-007","url":null,"abstract":"Objectives: Taxonomic assignment based on whole-genome sequencing data facilitates clear demarcation of species within a complex genus. Here, we applied a unique pan-genome phylogenetic method, open reading frame (ORF)-based binarized structure network analysis (OSNA), for taxonomic inference of Aeromonas spp., a complex taxonomic group consisting of 30 species.Methods: Data from 335 publicly available Aeromonas genomes, including the reference genomes of 30 species, were used to build a phylogenetic tree using OSNA. In OSNA, whole-genome structures are expressed as binary sequences based on the presence or absence of ORFs, and a tree is generated using neighbor-net, a distance-based method for constructing phylogenetic networks from binary sequences. The tree built by OSNA was compared to that constructed by a core-genome single-nucleotide polymorphism (SNP)-based analysis. Furthermore, the orthologous average nucleotide identity (OrthoANI) values of the sequences that clustered in a single clade in the OSNA-based tree were calculated.Results: The phylogenetic tree constructed with OSNA successfully delineated the majority of species of the genus Aeromonas forming conspecific clades for individual species, which was corroborated by OrthoANI values. Moreover, the OSNA-based phylogenetic tree demonstrated high compositional similarity to the core-genome SNP-based phylogenetic tree, supported by the Fowlkes-Mallows index.Conclusions: We propose that OSNA is a useful tool in predicting the taxonomic classification of complex bacterial genera.","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"10 1","pages":"8-15"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10847635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Retrospective analysis of urinary tract infections in long-term care facilities in Japan: Insights from physical examination-based diagnosis. 日本长期护理机构中尿路感染的回顾性分析：基于体格检查诊断的启示。

Fujita Medical Journal Pub Date : 2024-02-01 Epub Date: 2023-11-29 DOI: 10.20407/fmj.2023-012

Makoto Hasegawa, Yasuhiro Osugi, Yoshifumi Moriwaki, Yohei Doi

{"title":"Retrospective analysis of urinary tract infections in long-term care facilities in Japan: Insights from physical examination-based diagnosis.","authors":"Makoto Hasegawa, Yasuhiro Osugi, Yoshifumi Moriwaki, Yohei Doi","doi":"10.20407/fmj.2023-012","DOIUrl":"10.20407/fmj.2023-012","url":null,"abstract":"Objectives: Multidrug-resistant (MDR) bacterial infections are highly prevalent among long-term care facility (LTCF) residents, and are thus important targets for antimicrobial stewardship. Diagnoses of urinary tract infections (UTIs), which are associated with antimicrobial use in these facilities, are not always made by physicians. Past epidemiologic studies have included asymptomatic bacteriuria together with UTIs. The National Healthcare Safety Network has initiated a surveillance program to identify the causative organisms of UTIs in LTCF residents. In Japan, medical care for these residents is provided through in-person physician visits; however, limited related data are available. Therefore, we investigated the organisms causing UTIs and their drug susceptibility among LTCF residents in central Japan, and examined the prevalence of multidrug resistance, its risk factors, and correlations with clinical outcomes.Methods: We retrospectively evaluated clinical and urine culture data of LTCF residents with physician-diagnosed UTIs between April 1, 2019, and April 30, 2022.Results: The detection rate of multidrug-resistant organisms was high, with Escherichia coli being the most prevalent. Ceftriaxone was frequently used for initial therapy. The initial antimicrobial agents were significantly less active against MDR pathogens than non-MDR pathogens. Most residents continued to receive the initial agents regardless of culture results. Nonetheless, differences in the therapy duration, relapse and hospitalization rates, and death rate within 28 days between the multidrug-resistant and non-multidrug-resistant groups were not significant.Conclusions: Antimicrobial stewardship is essential for reducing antimicrobial use and selective pressure in LTCFs in Japan; however, more specific data are needed for its effective implementation.","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"10 1","pages":"24-29"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10847634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outbreak of novel coronavirus infection (COVID-19) in a child and adolescent psychiatric ward: Characteristics and responses. 儿童和青少年精神病院爆发新型冠状病毒感染（COVID-19）：特点和应对措施。

Fujita Medical Journal Pub Date : 2023-11-01 Epub Date: 2023-08-28 DOI: 10.20407/fmj.2023-003

Koichi Furuhashi

{"title":"Outbreak of novel coronavirus infection (COVID-19) in a child and adolescent psychiatric ward: Characteristics and responses.","authors":"Koichi Furuhashi","doi":"10.20407/fmj.2023-003","DOIUrl":"https://doi.org/10.20407/fmj.2023-003","url":null,"abstract":"Background: The novel coronavirus disease (COVID-19) pandemic has no end in sight. Currently, the emphasis is on policies aimed at easing movement restrictions and maintaining socio-economic activities. However, infection control in psychiatric hospitals has been challenging. There have been reports on the impact on mental health and outpatient/inpatient treatment environments in the field of child psychiatry. An outbreak of COVID-19 was experienced in a child and adolescent psychiatric ward, and considering that there have been few similar reports, it was deemed meaningful to accumulate such experiences.Case presentation: Three COVID-19-positive cases, all 14-year-old girls, were confirmed in a cluster among seven hospitalized patients in a child and adolescent psychiatric ward. Two patients presented symptoms of upper respiratory inflammation and one was asymptomatic. The main psychiatric diagnoses were post-traumatic stress disorder in one patient and autism spectrum disorder in the other two patients. The entire hospital ward was designated as a red zone (contaminated area), and infection control measures were adopted, such as halting group activities, wearing masks, and maintaining distance between patients. Additionally, it was necessary to use the infection control ward as it was difficult to ensure patient compliance.Conclusion: Infection control in COVID-19 clusters at child and adolescent psychiatric wards is difficult due to patient characteristics and symptoms. Restricted activities and care also result in psychobehavioral consequences, regardless of infection status. To achieve both infection control and a better treatment environment, it is necessary to make careful preparations while learning from these experiences.","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"9 4","pages":"301-305"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10701222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of online frame-of-reference training on assessment accuracy in the objective structured clinical examination for physical therapy students. 在线参照系培训对物理治疗专业学生客观结构化临床考试评估准确性的影响。

Fujita Medical Journal Pub Date : 2023-11-01 Epub Date: 2023-08-28 DOI: 10.20407/fmj.2022-032

Tetsuro Watari, Kei Ohtsuka, Yukari Suzuki, Fumihiro Matsuda, Soichiro Koyama, Naoki Aizu, Yoshikiyo Kanada, Hiroaki Sakurai

{"title":"Effects of online frame-of-reference training on assessment accuracy in the objective structured clinical examination for physical therapy students.","authors":"Tetsuro Watari, Kei Ohtsuka, Yukari Suzuki, Fumihiro Matsuda, Soichiro Koyama, Naoki Aizu, Yoshikiyo Kanada, Hiroaki Sakurai","doi":"10.20407/fmj.2022-032","DOIUrl":"https://doi.org/10.20407/fmj.2022-032","url":null,"abstract":"Objectives: This study investigates how online frame-of-reference (FOR) training of raters of the objective structured clinical examination (OSCE) for physical therapy students affects assessment accuracy.Methods: The research was conducted in a 1-month-long randomized controlled trial.Participants: The participants were 36 physical therapists without experience assessing clinical skills using the OSCE. The training group completed the FOR training online, which was conducted once a week in two 90-minute sessions. The control group self-studied the rubric rating chart used in the assessment. As a measure of accuracy, weighted kappa coefficients were used to check the agreement between correct score and those assessment by the participant in the OSCE.Results: The scores of the training group were higher than those of the control group in both post- and follow-up assessments, showing significant differences. No significant difference was found based on the assessment time and group for the high-agreement groups. Furthermore, scores of the low-accuracy training group were higher in the post- and follow-up assessments than those in the pre-assessment, showing significant differences.Conclusions: Online FOR training of the raters of the OSCE for physical therapists improved the assessment accuracy of the raters who had low accuracy in the pre-assessment; this improvement was maintained.","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"9 4","pages":"288-294"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10701224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Resting echocardiographic parameters to detect patients with less symptomatic primary mitral regurgitation who require exercise stress echocardiography. 用静息超声心动图参数检测需要进行运动负荷超声心动图检查的症状较轻的原发性二尖瓣反流患者。

Fujita Medical Journal Pub Date : 2023-11-01 Epub Date: 2023-08-28 DOI: 10.20407/fmj.2022-038

Yuka Kawada, Akira Yamada, Shinji Jinno, Chihiro Nakashima, Naoki Hoshino, Sayano Ueda, Meiko Hoshino, Sayuri Yamabe, Kayoko Takada, Kunihiko Sugimoto, Hideo Izawa

{"title":"Resting echocardiographic parameters to detect patients with less symptomatic primary mitral regurgitation who require exercise stress echocardiography.","authors":"Yuka Kawada, Akira Yamada, Shinji Jinno, Chihiro Nakashima, Naoki Hoshino, Sayano Ueda, Meiko Hoshino, Sayuri Yamabe, Kayoko Takada, Kunihiko Sugimoto, Hideo Izawa","doi":"10.20407/fmj.2022-038","DOIUrl":"https://doi.org/10.20407/fmj.2022-038","url":null,"abstract":"Objectives: We aimed to identify which resting echocardiographic parameters can detect asymptomatic or mildly symptomatic patients with primary mitral regurgitation (MR) who require exercise stress echocardiography (ESE) to determine their suitability for surgery.Methods: We examined 56 consecutive patients with primary moderate/severe MR who underwent ergometer-based ESE. Patients who met the surgical indications at rest were excluded. Eligible patients were divided into Group I (pulmonary artery systolic pressure [PASP] during exercise >60 mmHg; n=11) and Group II (PASP during exercise ≤60 mmHg; n=30).Results: Forty-one patients were included. Group I was significantly older (65±12 vs. 54±14 years, P=0.042) and had significantly higher serum N-terminal pro-B-type natriuretic peptide concentrations than Group II (351±278 vs. 125±163 pg/mL, P=0.002). The univariate analysis demonstrated that peak E wave velocity (Group I vs. Group II: 125±45 vs. 101±24 cm/sec, P=0.050), left ventricular (LV) end-diastolic diameter index (32±4 vs. 30±3 mm/m2, P=0.035), and left atrial volume index (LAVI; 45±14 vs. 30±11 mL/m2, P=0.008) were predictors of increased PASP during exercise. In the multivariate analysis, resting LAVI best predicted exercise-induced pulmonary hypertension (hazard ratio 1.081 [95% confidence interval 1.009-1.158], P=0.028), with a cutoff value of 37 mL/m2.Conclusions: In asymptomatic or mildly symptomatic patients with primary moderate/severe MR, increased resting LAVI indicates the requirement for ESE, even without LV dilatation.","PeriodicalId":33657,"journal":{"name":"Fujita Medical Journal","volume":"9 4","pages":"265-269"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10701221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0