Publications by authors named "Chizuko Kamiya"
Article Synopsis
- A study was conducted to investigate feelings of inequality in training and job satisfaction among Japanese cardiologists, targeting 14,798 members of the Japanese Circulation Society with a questionnaire.
- Survey results showed that 44.1% of female cardiologists and 42.0% of those under 45 perceived inequality in training opportunities, compared to 33.9% and 32.8% of their male and older counterparts, respectively.
- The findings suggest that younger and female cardiologists experience more career inequality and lower job satisfaction, indicating a need for a more diverse and supportive workplace to enhance equality in opportunities.
Background: Diversity and inclusion remain a concern in the field of cardiology. Female cardiologists have less opportunity to chair sessions in scientific meetings than men. However, cardiologists' awareness and perspectives on feasibility of chairing sessions is poorly understood.
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- Pregnant women with a Fontan circulation experience high rates of complications like preterm delivery and small for gestational age (SGA) infants due to reduced blood flow and oxygen issues affecting the placenta.
- A study involving 18 pregnancies revealed 9 miscarriages and 9 live births, with several cases of preterm delivery and SGA, alongside significant placental abnormalities in the live births analyzed.
- The findings highlighted that placentas from these pregnancies frequently exhibited low weight, chronic hemorrhaging, and various histological signs of hypoxia, indicating the impact of altered maternal health on pregnancy outcomes.
Chronic active Epstein-Barr virus (CAEBV) infection characterized by persistent infectious mononucleosis-like symptoms can lead to cardiovascular diseases. We encountered two pregnant women with CAEBV histories complicated with cardiovascular diseases. A 36-year-old woman with a history of myocardial infarction due to CAEBV and coronary artery bypass grafting became pregnant.
View Article and Find Full Text PDFBackground: Peripartum cardiomyopathy (PPCM) occurs in ≈1:2000 deliveries in the United States and worldwide. The genetic underpinnings of PPCM remain poorly defined. Approximately 10% of women with PPCM harbor truncating variants in (TTNtvs).
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- The study aimed to examine the occurrence and impact of pregnancy-related aortic dissection in Japan using data from a large-scale survey conducted from 2013 to 2017.
- Out of 407 perinatal centers, 70.5% responded, identifying 17 cases, with a significant maternal death rate of 56.2% linked to the dissection primarily during the postpartum period.
- Findings indicated that the mortality rate was high, especially for Stanford type A aortic dissections, and emphasized the need for thorough examinations if symptoms suggestive of aortic dissection arise after pregnancy.
Objective: To clarify the association between anesthetic technique and maternal and neonatal outcomes in parturients with congenital heart disease (CHD).
Design: Retrospective, observational cohort study.
Setting: An academic hospital.
Article Synopsis
- Pregnancy with mechanical heart valves poses a high risk of valve thrombosis due to increased blood clotting, and the use of warfarin is limited because it can harm the fetus.
- Managing a pregnant woman with mitral and aortic mechanical heart valves and placenta previa is challenging, as it can lead to severe postpartum bleeding.
- The case discussed highlights successful management using careful heparin dosage and monitoring, along with compression sutures to control bleeding from the placenta previa.
Article Synopsis
- This study explored pregnancy outcomes and long-term prognosis for women with dilated cardiomyopathy (DCM), analyzing 35 pregnancies in 30 women diagnosed prior to pregnancy.
- Results showed a high rate of preterm deliveries (43%) and identified risk factors like NYHA class II, certain medications, and heart function metrics that contributed to peripartum cardiac events in 23% of pregnancies.
- Although women with DCM tolerated pregnancy, the study found a significant decline in heart function after childbirth and poorer long-term survival rates post-pregnancy for those who experienced cardiac issues compared to those who did not.
Serial changes of electrocardiograms (ECG) could be used to assess their clinical features in atrial septal defects (ASD) after transcatheter closure together with other clinical parameters. We retrospectively studied 100 ASD patients who underwent transcatheter closure. Complications of persistent atrial fibrillation occurred in five ASD patients, and they were excluded.
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- This study examines how different delivery methods affect cardiac function in pregnant women with heart disease during labor, using a noninvasive method to measure hemodynamic changes.
- Results showed that vaginal delivery (VD) without epidural anesthesia increased cardiac index (CI) and heart rate (HR), while epidural anesthesia moderated these increases.
- The findings suggest that vaginal delivery with epidural anesthesia is preferred due to its balanced impact on stroke volume and heart rate, compared to caesarean section (CS) where different factors influenced cardiac function.
Background: The maternal circulatory system and hormone balance both change dynamically during pregnancy, delivery, and the postpartum period. Although atrial natriuretic peptides and brain natriuretic peptides produced in the heart control circulatory homeostasis through their common receptor, NPR1, the physiologic and pathophysiologic roles of endogenous atrial natriuretic peptide/brain natriuretic peptide in the perinatal period are not fully understood.
Methods: To clarify the physiologic and pathophysiologic roles of the endogenous atrial natriuretic peptide/brain natriuretic peptide-NPR1 system during the perinatal period, the phenotype of female wild-type and conventional or tissue-specific Npr1-knockout mice during the perinatal period was examined, especially focusing on maternal heart weight, blood pressure, and cardiac function.
Background: The average maternal age at delivery, and thus the associated maternal risk are increasing including in women with congenital heart disease (CHD). A comprehensive management approach is therefore required for pregnant women with CHD. The present study aimed to investigate the factors determining peripartum safety in women with CHD.
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- - Heparin anticoagulant therapy during pregnancy poses bleeding risks, leading researchers to implement a less-intensive protocol using unfractionated heparin (UFH) with specific therapeutic targets for APTT ratio and antithrombin activity.
- - A study involving ten pregnant Japanese patients showed that seven patients (heparin-sensitive group) maintained therapeutic levels, while three patients (heparin-resistant group) struggled, largely due to conditions like antithrombin deficiency.
- - Despite the challenges in the HR group, there were no major bleeding incidents or thromboembolic episodes in either group, suggesting that this less-intensive anticoagulation approach can be effective, especially for those who respond well to heparin.
Background Amlodipine is used for the treatment of hypertension, but reports on its use in early pregnancy are limited. Methods and Results In the present study, we recruited 231 women with chronic hypertension, including those who received amlodipine or other antihypertensives during early pregnancy, and investigated frequencies of morphologic abnormalities in their 231 offspring. Specifically, we evaluated 48 neonates exposed to amlodipine in the first trimester (amlodipine group, Group A), 54 neonates exposed to antihypertensives other than amlodipine (other antihypertensive group, Group O), and 129 neonates not exposed to antihypertensives (no-antihypertensive group, Group N).
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- - The study investigated how pregnancy affects aortic diameters in women with repaired conotruncal anomalies (CTA) compared to healthy pregnant women, analyzing echocardiography results over several years.
- - While no major maternal complications were found, women with repaired CTA experienced a greater increase in aortic diameter during pregnancy, with about 25% showing significant dilation that didn’t revert after delivery.
- - Key risk factors for increased and persistent aortic dilation included pulmonary atresia, prior surgeries, older age at the time of repair, and smaller heart size before pregnancy, indicating a need for regular monitoring of aortic root size during and after pregnancy.
Peripartum cardiomyopathy (PPCM) is a specific cardiomyopathy in which heart failure develops due to reduced myocardial contraction during pregnancy or in the postpartum period in women without a previous history of heart disease. The epidemiology of PPCM has been reported in various countries and areas, and the incidence of PPCM differed among these reports. The incidence was highest (1 in 102 deliveries) in Nigeria and lowest (1 in 15,533 births) in Japan.
View Article and Find Full Text PDFMaternal and fetal outcomes in pregnancy complicated with Eisenmenger syndrome.
Taiwan J Obstet Gynecol
March 2019
Article Synopsis
- The study aimed to identify risk factors for pregnancy complications in women diagnosed with Eisenmenger syndrome (ES), focusing on a group of 15 patients from 1982 to 2013.
- The results showed that while 10 women chose to terminate their pregnancies, 5 who continued faced severe complications like worsening cyanosis and heart symptoms, prompting early cesarean sections.
- The findings indicate that pregnancy in women with ES carries significant risks, necessitating careful monitoring and intervention due to potential heart failure and oxygenation issues that can arise as early as the second trimester.
Article Synopsis
- * The overall recurrence rate of CHD in these babies was found to be 3.1%, with specific rates varying depending on the type of maternal CHD, significantly higher than in the general population.
- * Notably, nearly 50% of neonates with CHD exhibited the same heart defect as their mothers, with the highest correlations seen in conditions like pulmonary stenosis (PS) and coarctation of the aorta (CoA).
Maternal circulatory dynamics change drastically during pregnancy and delivery. Therefore, pregnancy with concomitant cardiovascular disease has risks, even for maternal death, in severe cases. This condition has tended to increase with advances in medical care and an increase in the age of pregnant women.
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- The arterial switch operation (ASO) has become the standard treatment for pregnant women with dextro-transposition of the great arteries (d-TGA), replacing the older atrial switch operation.
- A study of 10 women showed that out of 20 pregnancies, 14 were successful with a majority resulting in term deliveries, although some faced complications like preterm labor and cardiovascular events.
- Findings suggest that while older age and high BNP levels increase risks during pregnancy, overall, women post-ASO have better mid-term outcomes compared to those who underwent the atrial switch operation.