Publications by authors named "Chie Bujo"

Lymphocytic myocarditis (LM) is primarily triggered by various factors including viral infections and subsequent immune responses. While rare, some patients with LM experience recurrence with a life-threatening fulminant form. Although combining steroids and immunosuppressants, such as azathioprine and mycophenolate mofetil, has demonstrated favourable outcomes in patients with LM, their efficacy is limited to the chronic phase.

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  • IBD is a chronic inflammatory condition that can develop post-heart transplant, as illustrated by a case of a 65-year-old man who developed Crohn's disease after his surgery.
  • Effective treatment included 5-aminosalicylic acid initially, but after a setback, ustekinumab brought his condition into remission.
  • It's important to consider IBD as a potential diagnosis for severe colitis in heart transplant patients, instead of only common issues like cytomegalovirus colitis.
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  • A left ventricular assist device (LVAD) is used to treat advanced heart failure but can lead to late right heart failure (LRHF), which increases risks for patients.
  • A study examined the right heart function of LVAD patients using a saline loading test one month after surgery, involving patients who underwent right heart catheterization.
  • Findings showed that lower pulmonary artery pulsatility index and right ventricular stroke work index after saline loading were linked to higher chances of LRHF and death, indicating that these measurements could help anticipate post-operative risks.
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  • The study examined how pre-transplant renal dysfunction affects post-heart transplant cardiac function and patient outcomes in those supported by a left ventricular assist device (LVAD).
  • The research included 132 patients who underwent heart transplantation, dividing them into groups based on kidney function (renal dysfunction vs. non-renal dysfunction).
  • Findings revealed that while cardiac function remained similar post-transplant, patients with renal dysfunction had higher mortality rates in the long term, highlighting the impact of kidney health on patient prognosis after heart transplant.
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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.

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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.

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Background: Driveline infection (DLI) following left ventricular assist device (LVAD) implantation remains an unresolved problem. Negative pressure wound therapy (NPWT) promotes wound healing by applying negative pressure on the surface of the wound. Recently, the prophylactic application of NPWT to closed surgical incisions has decreased surgical site infections in various postsurgical settings.

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  • The study compared hemodynamic outcomes and clinical events in heart transplant (HTx) patients based on their pulmonary vascular resistance (PVR) severity after left ventricular assist device (LVAD) implantation.
  • It analyzed 85 HTx recipients, finding significant differences in PVR and various pulmonary pressures between high (PVR > 3 WU) and low PVR groups, particularly notable at the 2-year mark post-transplant.
  • High residual PVR was associated with more frequent hospitalizations and increased intracardiac pressure, indicating its role as a critical predictor for adverse outcomes post-transplant.
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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.

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is a nontuberculous mycobacteria (NTM) with a predilection for skin and soft tissue infection (SSTI) in the immunocompromised host. We report a case of disseminated infection initially presenting as a nonresolving subacute cellulitis of bilateral lower extremities. Genetic sequencing was used for final identification, while a commercially available polymerase chain reaction test returned a false-positive result for .

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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.

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  • Late-onset right ventricular failure (RVF) is a significant complication following implantable left ventricular assist device (LVAD) use, typically appearing weeks after surgery without clear preoperative signs.
  • The condition may be linked to changes in heart structure due to LVAD effects, such as septum shift, and is associated with increased risks of aortic insufficiency and ventricular arrhythmia, leading to diminished exercise capacity and higher mortality.
  • Treatment primarily focuses on managing fluid levels and may involve adjusting medication dosages, such as reducing β-blockers and antiarrhythmics, while considering pulmonary vasodilators to alleviate right ventricular pressure; however, finding optimal LVAD settings remains challenging.
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Background: Implantable continuous-flow left ventricular assist device (LVAD) improve renal function in advanced heart failure. However, the long-term effects of LVAD on renal function have not been investigated thoroughly. We aimed to assess long-term renal function in patients with LVAD support and to identify predictors for late deterioration in renal function (LDRF).

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Background: Little evidence has been presented about the association between previous atopic/allergic disease and graft rejection after solid organ transplantation. Thus, we present a case wherein acute cellular rejection (ACR) after heart transplantation (HTx) was noted along with exacerbation of atopic disease.

Case Summary: A 32-year-old man was admitted at our hospital for regular monitoring of graft rejection.

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Carbon monoxide diffusion capacity (DLCO) is impaired in heart failure patients; however, its clinical impact has not been well investigated in the left ventricular assist device (LVAD) population. We explored the predictive value of preoperative DLCO in the survival and cardiac readmission rates after LVAD implantation. Seventy-six patients who received continuous-flow LVAD as bridge-to-transplant therapy from November 2007 to September 2018 and underwent pulmonary function test before LVAD implantation were included.

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Few reports have discussed appropriate strategies for patient referrals to advanced heart failure (HF) centers with available left ventricular assist devices (LVADs). We examined the association between the characteristics and prognoses of referred patients with advanced HF and the bed volume of the referring hospitals. This retrospective analysis evaluated 186 patients with advanced HF referred to our center for consultation about the indication of LVAD between January 1, 2015, and August 31, 2018.

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The aim of the study was to investigate the incidence of and risk factors for de novo malignancy after heart transplantation (HTx) in a single center. We assessed 102 consecutive patients who received HTx and were followed-up in our center regularly for > 1 year from June 2006 to May 2018. We investigated the incidence of and risk factors for de novo malignancy.

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  • Heart transplantation is a successful treatment for severe heart failure, but cases of Takotsubo syndrome (TTS) can occur in donor hearts.
  • A 40-year-old woman with a history of seizures received a heart transplant from a donor with TTS and was later readmitted for seizures, revealing TTS signs through various tests.
  • On diagnosing TTS related to her seizures, the case highlights the need to monitor heart transplant patients from TTS donors for potential recurrent TTS.
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Aims: Nephrotoxicity of calcineurin inhibitors (CNIs) is associated with adverse events in patients undergoing heart transplant (HTx), although studies directly comparing tacrolimus (TAC) versus cyclosporin A (CsA), especially in combination with everolimus and low-dose CNIs approach, are limited. Thus, we sought to investigate the associations of TAC and CsA with clinical outcomes in HTx recipients, with specific focus on renal function.

Methods And Results: From August 2007 to February 2017, 72 consecutive patients (39 treated with TAC vs.

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Respiratory muscle weakness is often complicated in patients with heart failure. Its presence further worsens the clinical course of heart failure. However, the effect and appropriate method of inspiratory muscle training has not previously been elucidated.

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The precise physiological changes associated with the use of left ventricular assist device (LVAD) are not well characterized. We examined the impact of changes in hemodynamic state using LVAD on endothelial function. We measured flow-mediated vasodilation (FMD) to evaluate endothelial vasodilator function of the brachial artery in 53 patients (dilated cardiomyopathy: 39, ischemic cardiomyopathy: 4, and others: 10) with an implanted LVAD (DuraHeart, EVAHEART, or HeartMate II).

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Background: Continuous-flow left ventricular assist devices (LVADs) improve survival and morbidity in patients with stage D heart failure. Management of LVADs for longer durations is necessary in some clinical settings, and a better understanding of the hemodynamics of patients using LVADs is warranted. Arrhythmia, including atrial (AA) and ventricular (VAs) arrhythmias, is a modifying factor of hemodynamics that is highly prevalent among patients with LVADs.

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