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Predictor Analysis of Mid-Term Left Atrial Reverse Remodeling after Mitral Valve Surgery

World Journal of Cardiovascular Surgery 2013年第2期3卷 52-57页

作者： Kaoru Matsuura Kenji Mogi Manabu Sakurai Tomonori Kawamura yoshiharu takahara Funabashi Municipal Medical Center Department of Cardiovascular Surgery Chiba Japan

Objective: The aim of this study was to predict mid-term left atrial reverse remodeling after mitral valve surgery. Patients and Methods: Echocardiographic data was obtained preoperatively and at follow-up from 105 patients who underwent mitral valve surgery. Left atrial volume (LAV) was decreased by >30% from baseline in 43 patients (group A), but not in 62 patients (group B). Results: Patients in group A were younger (p = 0.0029). Male was more (p = 0.05) and prosthesis size was bigger in group A (p = 0.005). Only age was a predictor of left atrial reverse remodeling in a logistic regression model (OR = 0.93, 95% CI 0.88 - 0.99;p = 0.03). Late mean trans-mitral pressure gradient was lower in group A than in group B (p = 0.01). There was a weak correlation between the change in left ventricular end-diastolic diameter (LVDd) and LAV (correlation coefficient 0.27, 95% CI 0.07 - 0.45;p = 0.008). Survival and freedom from major adverse cardiac events did not differ between the groups (p = 0.31 and p = 0.87 by log-rank test). Conclusions: Age was the only predictor of left atrial reverse remodeling. There was a weak correlation between changes in LVDd and LAV.

关键词： Atrium Mitral Valve Outcomes

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Development of osteomalacia in a post-liver transplant patient receiving adefovir dipivoxil

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World Journal of Hepatology 2010年第12期2卷 442-446页

作者： Masami Minemura yoshiharu Tokimitsu Kazuto Tajiri Yasuhiro Nakayama Kengo Kawai Hiroshi Kudo Katsuharu Hirano Yoshinari Atarashi Yutaka Yata Satoshi Yasumura Terumi takahara Toshiro Sugiyama Third Department of Internal Medicine Faculty of MedicineUniversity of Toyama

We report the case of a patient treated with living donor-related liver transplantation who suffered from osteomalacia during adefovir dipivoxil (ADV)-containing antiviral therapy for lamivudine-resistant hepatitis B virus infection. The patient had generalized bone pain,with severe hypophosphatemia after 20 mo of ADV therapy. Radiographic studies demonstrated the presence of osteomalacia. The peak plasma ADV level was 38 ng/mL after administration of ADV at 10mg/day. It was also found that ADV affected the metabolism of tacrolimus,a calcineurin-inhibitor,and caused an increase in the plasma levels of tacrolimus. The disability was reversed with the withdrawal of ADV and with mineral supplementation. ADV can cause an elevation of plasma tacrolimus levels,which may be associated with renal dysfunction. High levels of ADV and tacrolimus can cause nephrotoxicity and osteomalacia. This case highlights the importance of considering a diagnosis of osteomalacia in liver transplantation recipients treated with both ADV and tacrolimus.

关键词： Hepatitis B virus Osteomalacia Adefovir dipivoxil Living donor-related liver transplantation Tacrolimus

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