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Article ; Online: Right heart reserve function assessed with fluid loading predicts late right heart failure after left ventricular assist device implantation.

Tsuji, Masaki / Kurihara, Takahiro / Isotani, Yoshitaka / Bujo, Chie / Ishida, Junichi / Amiya, Eisuke / Hatano, Masaru / Shimada, Asako / Imai, Hiroko / Kimura, Mitsutoshi / Shimada, Shogo / Ando, Masahiko / Ono, Minoru / Komuro, Issei

The Canadian journal of cardiology

2024

Abstract: Background: A left ventricular assist device (LVAD) is an effective therapeutic option for advanced heart failure. Late right heart failure (LRHF) is a complication after LVAD implantation associated with increasing morbidity and mortality; however, the ...

Abstract	Background: A left ventricular assist device (LVAD) is an effective therapeutic option for advanced heart failure. Late right heart failure (LRHF) is a complication after LVAD implantation associated with increasing morbidity and mortality; however, the assessment of right heart function, including right heart reserve function after LVAD implantation, has not been established. We focused on a fluid loading test with right heart catheterization (RHC) to evaluate right heart pre-load reserve function and investigate its impact on LRHF. Methods: Patients aged > 18 who received continuous-flow LVAD between November 2007 and December 2022 at our institution and underwent RHC with saline loading (10ml/kg for 15 min) 1 month after LVAD implantation were included. Results: Overall, 31 LRHF or deaths (RHF group) have occurred in 149 patients. Comparing the RHF and non-RHF groups, pulmonary artery pulsatility index (PAPi) at rest (1.8±0.89 vs. 2.5±1.4, p=0.02) and right ventricular stroke work index (RVSWi) change ratio with saline loading (0.96±0.32 vs. 1.1±0.20, p=0.03) was significantly different. The PAPi at rest and RVSWi change ratio with saline loading were identified as the postoperative risks for LRHF or death. The cohort was divided into three groups based on whether the PAPi at rest and RVSWi change ratio were low. The event-free curve significantly differed between the three groups (p<0.001). Conclusions: Hemodynamic assessment with saline loading can evaluate the right ventricular pre-load reserve function of patients with LVAD. The low RVSWi change with saline loading was a risk factor for LRHF following LVAD implantation.
Language	English
Publishing date	2024-02-23
Publishing country	England
Document type	Journal Article
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2024.02.012
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Article ; Online: The first case report of de novo Crohn's disease after heart transplantation successfully treated with ustekinumab.

Okamura, Shun / Bujo, Chie / Amiya, Eisuke / Kurokawa, Ken / Hatano, Masaru / Ishida, Junichi / Tsuji, Masaki / Ihara, Sozaburo / Murakami, Keita / Shiomi, Chihiro / Hayakawa, Yoku / Fujishiro, Mitsuhiro / Ono, Minoru / Komuro, Issei

Journal of cardiology cases

2024 Volume 29, Issue 4, Page(s) 174–177

Abstract: Inflammatory bowel disease (IBD) is a complex chronic inflammatory intestinal disease. The development of de novo IBD after solid organ transplantation with immunosuppressive agents has been rarely reported. We present the case of a 65-year-old man with ... ...

Abstract	Inflammatory bowel disease (IBD) is a complex chronic inflammatory intestinal disease. The development of de novo IBD after solid organ transplantation with immunosuppressive agents has been rarely reported. We present the case of a 65-year-old man with repeated colitis after heart transplantation (HTx) who was diagnosed with Crohn's disease (CD). The patient underwent HTx due to non-ischemic dilated cardiomyopathy. Six months after HTx, he developed serious diarrhea and a transient fever, which persisted for about 6 months. Valganciclovir or any antibiotic agents were not effective for his symptoms and longitudinal ulcers in colonoscopy aggravated during the course, so that we made a diagnosis of CD. We started 5-aminosalicylic acid and found improvement in his symptoms and colonoscopic findings. However, 7 months after improvement, CD worsened. We started ustekinumab by which his condition successfully went into remission again. While oral immunosuppressive drugs are thought to suppress autoimmune diseases in general, IBD should be included in the differential diagnoses for recurring enterocolitis after HTx. Poorly controlled CD can lead to serious and potentially fatal complications, but in this case, ustekinumab has been used safely and effectively for the treatment of CD. Learning objective: Colitis is a common complication after heart transplantation (HTx). Although cytomegalovirus colitis or posttransplant lymphoproliferative disorder are observed commonly, de novo inflammatory bowel disease (IBD) should be considered when serious refractory colitis occurs. Not only 5-aminosalicylic acid but also ustekinumab, which is a monoclonal antibody to the p40 subunit of interleukin (IL)-12 and IL-23, may be a safe and effective treatment for de novo IBD after HTx.
Language	English
Publishing date	2024-01-15
Publishing country	Japan
Document type	Case Reports
ISSN	1878-5409
ISSN (online)	1878-5409
DOI	10.1016/j.jccase.2023.12.005
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Article ; Online: Successful Treatment with Letermovir in a Heart Transplant Recipient with UL97 Mutation Ganciclovir-Resistant Cytomegalovirus Colitis and Viremia.

Yanase, Tomonobu / Hatano, Masaru / Bujo, Chie / Tsuji, Masaki / Ishida, Junichi / Amiya, Eisuke / Okamoto, Koh / Ando, Masahiko / Shimada, Shogo / Kinoshita, Osamu / Fukushi, Shuetsu / Yamada, Souichi / Ono, Minoru / Komuro, Issei

International heart journal

2023 Volume 64, Issue 1, Page(s) 95–99

Abstract: Currently available anti-cytomegalovirus (CMV) agents are sometimes poorly tolerated, owing to their side effects. Letermovir is a novel anti-CMV drug that is only approved for CMV prophylaxis in hematopoietic stem cell transplant recipients, with fewer ... ...

Abstract	Currently available anti-cytomegalovirus (CMV) agents are sometimes poorly tolerated, owing to their side effects. Letermovir is a novel anti-CMV drug that is only approved for CMV prophylaxis in hematopoietic stem cell transplant recipients, with fewer side effects. We report the case of a heart transplant recipient with UL97 mutation (L595F) ganciclovir-resistant cytomegalovirus colitis who was successfully treated with off-label use of letermovir. In treating CMV infection or disease with letermovir, a transient rise or lag in the clearance of CMV-DNA polymerase chain reaction levels has been observed. Our case suggests that CMV-pp65 antigenemia can be an additional marker of treatment efficacy.
MeSH term(s)	Humans ; Ganciclovir/therapeutic use ; Ganciclovir/pharmacology ; Antiviral Agents/therapeutic use ; Antiviral Agents/pharmacology ; Viremia/drug therapy ; Viremia/etiology ; Cytomegalovirus Infections/drug therapy ; Cytomegalovirus Infections/prevention & control ; Cytomegalovirus/genetics ; Mutation ; Heart Transplantation/adverse effects
Chemical Substances	Ganciclovir (P9G3CKZ4P5) ; letermovir (1H09Y5WO1F) ; Antiviral Agents
Language	English
Publishing date	2023-01-23
Publishing country	Japan
Document type	Case Reports ; Journal Article
ZDB-ID	2187806-7
ISSN	1349-3299 ; 1349-2365
ISSN (online)	1349-3299
ISSN	1349-2365
DOI	10.1536/ihj.22-496
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Article ; Online: Late-onset right ventricular failure after continuous-flow left ventricular assist device implantation: case presentation and review of the literature.

Hatano, Masaru / Jimba, Takahiro / Fujiwara, Takayuki / Tsuji, Masaki / Bujo, Chie / Ishida, Junichi / Amiya, Eisuke / Kinoshita, Osamu / Ono, Minoru

Journal of cardiology

2021 Volume 80, Issue 2, Page(s) 110–115

Abstract: With the widespread use of implantable left ventricular assist device (LVAD), right ventricular failure (RVF) has become a serious problem that becomes apparent several weeks or later after LVAD implantation. However, there are no marked preoperative ... ...

Abstract	With the widespread use of implantable left ventricular assist device (LVAD), right ventricular failure (RVF) has become a serious problem that becomes apparent several weeks or later after LVAD implantation. However, there are no marked preoperative signs of RVF. This is called late-onset RVF and is currently a major problem leading to long-term complications following implantable LVAD use. Pathogenically, this could be the result of left ventricular suction by LVAD that causes the septum shift to the left ventricular side. This causes a change in morphology of the right ventricle, resulting in impaired right ventricular function. Aortic insufficiency and ventricular arrhythmia, which are also important as long-term complications after LVAD implantation, are considered to be closely involved in the onset and progression of RVF. Once late-onset RVF develops, exercise capacity declines and inotrope administration may be required. Late-onset RVF was also reported to be significantly associated with increased mortality. Several predictors of RVF have been proposed such as preoperative left ventricular diastolic dimension <64 mm, tricuspid valve annulus diameter ≥41 mm, and so on. However, some reports identified no predictors. The basic treatment strategy for late-onset RVF is to optimize volume status by administering diuretics and ensuring inotrope as needed. β-blockers and antiarrhythmic agents often need to be reduced in terms of dosage or even discontinued because these might reduce right ventricular function. Although their efficacy is unclear, pulmonary vasodilators may be used to reduce right ventricular afterload. It is better to decrease the rotation speed of LVAD to minimize the displacement of the septum; however, this is often difficult because the required flow rate cannot be secured. Progress in the prevention and management of late-onset RVF is required because the number of patients who require longer-term LVAD support will increase with the spread of LVAD use as destination therapy.
MeSH term(s)	Heart Failure/etiology ; Heart Failure/therapy ; Heart Ventricles/diagnostic imaging ; Heart-Assist Devices/adverse effects ; Humans ; Retrospective Studies ; Ventricular Dysfunction, Right/etiology ; Ventricular Dysfunction, Right/therapy ; Ventricular Function, Right
Language	English
Publishing date	2021-12-30
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	639364-0
ISSN	1876-4738 ; 0386-2887 ; 0914-5087
ISSN (online)	1876-4738
ISSN	0386-2887 ; 0914-5087
DOI	10.1016/j.jjcc.2021.12.009
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Article ; Online: A new assessment method for right ventricular diastolic function using right heart catheterization by pressure-volume loop.

Isotani, Yoshitaka / Amiya, Eisuke / Hatano, Masaru / Kiriyama, Hiroyuki / Uehara, Masae / Ishida, Junichi / Tsuji, Masaki / Bujo, Chie / Narita, Koichi / Ishii, Satoshi / Kakuda, Nobutaka / Minatsuki, Shun / Yagi, Hiroki / Saito, Akihito / Numata, Genri / Yamada, Takanobu / Kurihara, Takahiro / Suzuki, Tatsuya / Komuro, Issei

Physiological reports

2023 Volume 11, Issue 13, Page(s) e15751

Abstract: Diastolic stiffness coefficient (β) and end-diastolic elastance (Eed) are ventricular-specific diastolic parameters. However, the diastolic function of right ventricle had not been investigated sufficiently due to the lack of established evaluation ... ...

Abstract	Diastolic stiffness coefficient (β) and end-diastolic elastance (Eed) are ventricular-specific diastolic parameters. However, the diastolic function of right ventricle had not been investigated sufficiently due to the lack of established evaluation method. We evaluated the validity of these parameters calculated using only data of right heart catheterization (RHC) and assessed it in patients with restrictive cardiomyopathy (RCM) and cardiac amyloidosis. We retrospectively analyzed 46 patients with heart failure who underwent RHC within 10 days of cardiac magnetic resonance (CMR). Right ventricular end-diastolic volume and end-systolic volume were calculated using only RHC data, which were found to be finely correlated with those obtained from CMR. β and Eed calculated by this method were also significantly correlated with those derived from conventional method using CMR. By this method, β and Eed were significantly higher in RCM with amyloidosis group than dilated cardiomyopathy group. In addition, the β and Eed calculated by our method were finely correlated with E/A ratio on echocardiography. We established an easy method to estimate β and Eed of right ventricle from only RHC. The method finely demonstrated right ventricular diastolic dysfunction in patients with RCM and amyloidosis.
MeSH term(s)	Humans ; Retrospective Studies ; Diastole ; Magnetic Resonance Imaging ; Echocardiography ; Cardiac Catheterization ; Stroke Volume ; Ventricular Function, Right ; Ventricular Dysfunction, Right/diagnostic imaging
Language	English
Publishing date	2023-07-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2724325-4
ISSN	2051-817X ; 2051-817X
ISSN (online)	2051-817X
ISSN	2051-817X
DOI	10.14814/phy2.15751
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Article ; Online: Effect of renal function under left ventricular assist device support on the cardiac function and clinical events after heart transplantation.

Kakuda, Nobutaka / Amiya, Eisuke / Hatano, Masaru / Ishida, Junichi / Tsuji, Masaki / Bujo, Chie / Yagi, Hiroki / Fujita, Kanna / Ishii, Satoshi / Isotani, Yoshitaka / Kurihara, Takahiro / Numata, Genri / Gyoten, Takayuki / Shimada, Shogo / Ando, Masahiko / Ono, Minoru / Komuro, Issei

Clinical transplantation

2023 Volume 37, Issue 12, Page(s) e15107

Abstract: Aim: We investigated the effects of pre-transplantation renal dysfunction under left ventricular assisted device (LVAD) support on post-transplantation cardiac function, and patient prognosis after heart transplantation (HTx).: Method: All patients ... ...

Abstract	Aim: We investigated the effects of pre-transplantation renal dysfunction under left ventricular assisted device (LVAD) support on post-transplantation cardiac function, and patient prognosis after heart transplantation (HTx). Method: All patients who were bridged by LVAD and underwent HTx at our hospital between 2007 and 2022 were included in this study. Patients were classified into two groups based on estimated glomerular filtration rate (eGFR) before HTx: renal dysfunction (RD) group (eGFR < 60 mL/min/1.73 m Result: A total of 132 patients were analyzed, of whom 48 were classified into the RD group and 84 into the NRD group (RD group, 47.9 ± 10.1 years; NRD group, 38.4 ± 11.9 years, p < .0001). Under LVAD support before HTx, the RD group tended to have a history of right ventricular failure (RD group, nine (19%); NRD group, seven (8%); p = .098). After HTx, the echocardiographic parameters did not differ between the two groups in the long term. Furthermore, more concise hemodynamic parameters, exemplified by right heart catheterization, were not significantly different between the two groups. Regarding graft rejection, no significant differences were found in acute cellular rejection and cardiac allograft vasculopathy following HTx. In contrast, patients with RD before HTx had significantly increased mortality in the chronic phase after HTx and initiation of maintenance dialysis, without any overt changes in cardiac function. Conclusion: Pre-transplantation renal dysfunction under LVAD support significantly affected clinical course after HTx without any overt changes in graft cardiac function.
MeSH term(s)	Humans ; Heart-Assist Devices/adverse effects ; Treatment Outcome ; Heart Transplantation/adverse effects ; Heart Failure ; Kidney Diseases ; Kidney
Language	English
Publishing date	2023-08-24
Publishing country	Denmark
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.15107
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Article: Determining the factors for interhospital transfer in advanced heart failure cases.

Narita, Koichi / Amiya, Eisuke / Hatano, Masaru / Ishida, Junichi / Minatsuki, Shun / Tsuji, Masaki / Bujo, Chie / Kakuda, Nobutaka / Isotani, Yoshitaka / Ono, Minoru / Komuro, Issei

International journal of cardiology. Heart & vasculature

2022 Volume 40, Page(s) 101035

Abstract: Background: There are some patients with advanced heart failure (HF), for whom implantable left ventricular assist device (LVAD) or heart transplantation (HTx) should be considered. Some of them need to be transferred between hospitals. There are few ... ...

Abstract	Background: There are some patients with advanced heart failure (HF), for whom implantable left ventricular assist device (LVAD) or heart transplantation (HTx) should be considered. Some of them need to be transferred between hospitals. There are few reports on the interhospital transfer of patients with advanced HF and their subsequent clinical course.In this study, we investigated the characteristics and clinical course of patients transferred to a LVAD/HTx center, focusing on the distance between hospitals. Methods: We retrospectively examined 141 patients who were transferred to our hospital, considering the indications of LVAD implantation or HTx. We divided the patients into two groups: those referred <33 km (short-distance) and those referred more than 33 km (long-distance). The primary outcome was the composite outcome of increased catecholamine dose, mechanical support, or renal dysfunction within 1 week of transfer. Results: Continuous catecholamine infusion was significantly more common in patients in the long-distance group, whereas extracorporeal membrane oxygenation (ECMO) placement was significantly more common in short-distance group.Patients transferred via long distance had significantly higher rates of increased catecholamine doses, mechanical support including intra-aortic balloon pumping (IABP) and ECMO, and renal dysfunction within 1 week of transfer than patients transferred via short distance. Multivariate analysis showed that low body mass index (BMI) and long distance were independent predictive factors for the primary outcome. Conclusions: When patients with advanced HF are transferred from far distant hospitals or with low BMI, it may be necessary to devise various measures for interhospital transport.
Language	English
Publishing date	2022-05-14
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	2818464-6
ISSN	2352-9067
ISSN	2352-9067
DOI	10.1016/j.ijcha.2022.101035
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Article: Residual Pulmonary Vascular Resistance Increase Under Left Ventricular Assist Device Support Predicts Long-Term Cardiac Function After Heart Transplantation.

Kakuda, Nobutaka / Amiya, Eisuke / Hatano, Masaru / Tsuji, Masaki / Bujo, Chie / Ishida, Junichi / Yagi, Hiroki / Saito, Akihito / Narita, Koichi / Isotani, Yoshitaka / Fujita, Kanna / Ando, Masahiko / Shimada, Shogo / Kinoshita, Osamu / Ono, Minoru / Komuro, Issei

Frontiers in cardiovascular medicine

2022 Volume 9, Page(s) 904350

Abstract: Aims: We compared hemodynamics and clinical events after heart transplantation (HTx) in patients stratified by the severity of residual pulmonary vascular resistance (PVR) after left ventricular assist device (LVAD) implantation for bridge to ... ...

Abstract	Aims: We compared hemodynamics and clinical events after heart transplantation (HTx) in patients stratified by the severity of residual pulmonary vascular resistance (PVR) after left ventricular assist device (LVAD) implantation for bridge to transplantation. Methods: We retrospectively analyzed patients who had undergone HTx at the University of Tokyo Hospital. We defined the high PVR group as patients with PVR of >3 Wood Units (WU) as measured by right heart catheterization performed 1 month after LVAD implantation. Results: We included 85 consecutive HTx recipients, 20 of whom were classified in the high PVR group and 65 in the low PVR group. The difference in PVR between the two groups became apparent at 2 years after HTx (the high PVR group: 1.77 ± 0.41 WU, the low PVR group: 1.24 ± 0.59 WU, Conclusion: Our study demonstrates that patients with residual high PVR under LVAD implantation showed the increase of right and left atrial pressure in the chronic phase after HTx.
Language	English
Publishing date	2022-06-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2022.904350
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Article ; Online: Sarcopenia and risk of infection in adult heart transplant recipients in Japan.

Tsuji, Masaki / Kakuda, Nobutaka / Bujo, Chie / Ishida, Junichi / Amiya, Eisuke / Hatano, Masaru / Shimada, Asako / Imai, Hiroko / Shimada, Shogo / Kinoshita, Osamu / Yamauchi, Haruo / Ono, Minoru / Komuro, Issei

ESC heart failure

2022 Volume 9, Issue 2, Page(s) 1413–1423

Abstract: Aims: Heart transplantation (HT) is an effective therapeutic option for end-stage heart failure. Infection is a major cause of morbidity and mortality after HT. Sarcopenia, defined as the loss of muscle mass and strength, is a common comorbidity in HT ... ...

Abstract	Aims: Heart transplantation (HT) is an effective therapeutic option for end-stage heart failure. Infection is a major cause of morbidity and mortality after HT. Sarcopenia, defined as the loss of muscle mass and strength, is a common comorbidity in HT candidates with end-stage heart failure. However, the effects of sarcopenia on the occurrence of post-HT infections are not well understood. Therefore, we explored the association between the skeletal muscle mass and post-transplant infections in adult HT recipients. Methods and results: We retrospectively examined the records of 135 patients who underwent HT between August 2007 and November 2019 at our institution. Pre-transplant computed tomography was used to calculate the skeletal muscle index (SMI) at the level of the third lumbar vertebra. Muscle wasting was defined as the SMI of the lowest sex-based tertiles. The primary endpoint was infections within 6 months of HT. The study included 109 patients (80 men, mean age: 41.6 ± 12.0 years): 37 patients in the muscle wasting group and 72 patients in the non-muscle wasting group. The mean SMI values in the muscle wasting and non-muscle wasting groups were 29.9 ± 4.8 cm Conclusions: Low skeletal muscle mass is a predictor of post-HT infections within 6 months of HT.
MeSH term(s)	Adult ; Heart Transplantation/adverse effects ; Humans ; Japan/epidemiology ; Male ; Middle Aged ; Muscle, Skeletal/pathology ; Retrospective Studies ; Sarcopenia/epidemiology ; Sarcopenia/etiology
Language	English
Publishing date	2022-02-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2814355-3
ISSN	2055-5822 ; 2055-5822
ISSN (online)	2055-5822
ISSN	2055-5822
DOI	10.1002/ehf2.13835
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Article: A Cold-Blooded Tiptoer: Nonresolving Cellulitis in an Immunocompromised Patient.

Kitaura, Satoshi / Okamoto, Koh / Wakabayashi, Yoshitaka / Okada, Yuta / Okazaki, Aiko / Ikeda, Mahoko / Okugawa, Shu / Fujimoto, Fumie / Bujo, Chie / Minatsuki, Shun / Tsushima, Kensuke / Chikamatsu, Kinuyo / Mitarai, Satoshi / Moriya, Kyoji

Open forum infectious diseases

2022 Volume 9, Issue 4, Page(s) ofac074

Abstract: Mycobacterium ... ...

Abstract	Mycobacterium haemophilum
Language	English
Publishing date	2022-02-11
Publishing country	United States
Document type	Case Reports
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofac074
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