Clinical characteristics of acute pulmonary thromboembolism in Japan: Results of a multicenter registry in the japanese society of pulmonary embolism research

Nakamura, Mashio; Fujioka, Hirofumi; Yamada, Norikazu; Nakano, Takeshi; Sakuma, Masashi; Okada, Osamu; Kuriyama, Takayuki; Nakanishi, Norifumi; Miyahara, Yoshiyuki; Kunieda, Takeyoshi; Sugimoto, Tsuneaki

doi:10.1002/clc.4960240207

Cited by 159 publications

(146 citation statements)

References 20 publications

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“…PE Perfusion MRI index was 85.0%. 533 patients with PE reported in-hospital mortality rate of 14.0% (37). Our mortality rate of 16% can thus be considered to be comparable.…”

Section: Discussionsupporting

confidence: 57%

Dynamic MR perfusion imaging: Capability for quantitative assessment of disease extent and prediction of outcome for patients with acute pulmonary thromboembolism

Ohno

Koyama

Matsumoto

et al. 2010

Magnetic Resonance Imaging

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Purpose: To compare directly the capabilities of multidetector-row computed tomography (MDCT) and MRI for disease severity assessment and outcome prediction for acute pulmonary thromboembolism (APTE) patients. Materials and Methods:Fifty consecutive APTE patients underwent MDCT, MR angiography, dynamic perfusion MRI, treatment and follow-up examination. Pulmonary blood flow (PBF), pulmonary blood volume, and mean transit time maps were generated from perfusion MRI, and all segmental parameters were determined by using region of interest measurements. Receiver operator curve analyses were used to determine the most accurate parameter for diagnosis of the APTE segment. Then, APTE index from perfusion MRI (PE perfusion MRI index), right ventricle/left ventricle (RV/LV) diameter ratio and APTE indexes from embolic burdens observed on MDCT (PE CT index) and MR angiography (PE MRA index) were calculated. Finally, ability to differentiate mortality (n ¼ 8) from survival (n ¼ 42) groups and to predict patient outcome were statistically assessed.Results: PBF was a significantly more accurate parameter than others (P < 0.05). When feasible threshold value was applied, specificity and accuracy of RV/LV diameter ratio and PE Perfusion MRI index were significantly higher than those of PE CT and PE MRA indexes (P < 0.05). Logistic regression analysis demonstrated that each index was a significant predictor (P < 0.05).Conclusion: Dynamic perfusion MRI can be effective for disease extent assessment and outcome prediction for APTE patients.

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“…PE Perfusion MRI index was 85.0%. 533 patients with PE reported in-hospital mortality rate of 14.0% (37). Our mortality rate of 16% can thus be considered to be comparable.…”

Section: Discussionsupporting

confidence: 57%

Dynamic MR perfusion imaging: Capability for quantitative assessment of disease extent and prediction of outcome for patients with acute pulmonary thromboembolism

Ohno

Koyama

Matsumoto

et al. 2010

Magnetic Resonance Imaging

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“…These findings were consistent with the characteristics of Japanese patients reported earlier. 4,5,19 When the clinical characteristics were compared between the DVT-positive patients and the DVT-negative patients, there was no statistically significant difference (Table 1).…”

Section: Resultsmentioning

confidence: 96%

“…12 In addition, several risk factors for CTEPH have been identified, including chronic inflammatory disorders, myeloproliferative syndromes and splenectomy. 4,13 These observations implied that inflammatory or immune-related mechanisms might be involved in the pathogenesis of CTEPH. In accordance with this hypothesis, HLA analyses had been done in patients with primary pulmonary hypertension, and it was reported that certain types of HLA antigens or HLA alleles, such as HLA-B35, -DR3, -DR6, -DR52, -DQ2 and -DQ7, were associated with the disease in Caucasoid populations.…”

Section: Introductionmentioning

confidence: 90%

“…[1][2][3] CTEPH is a rare disease with an estimated annual incidence of 500-2500 patients in USA. 2 It is further rare in Japan, 4 where the prevalence of CTEPH was estimated to be 450 patients, which is about one-tenth of that in the United States (http://www.nanbyou.or.jp/sikkan/081.htm). It is accepted that continuous influx of venous thrombi mainly leads to the formation and progression of pulmonary thromboembolism, and that deep vein thrombosis (DVT) and/or coagulation factor variants are predisposing factors of CTEPH.…”

Section: Introductionmentioning

confidence: 99%

“…An especially lower prevalence rate of DVT in Japanese patients as compared with Caucasian patients (12-38% in Japan vs 35-45% in the United States) has been reported, implying the presence of different clinical categories, that is, DVT-positive CTEPH and DVTnegative CTEPH, and/or ethnic difference in the etiology of CTEPH. 2,[4][5][6] The human leukocyte antigen (HLA) locus spans about 4 Mb on chromosome 6p21.3 and contains more than 200 genes, including genes for HLA molecules that are involved in the immune responsiveness to foreign and self-antigens. [7][8][9] It is well known that HLA genes are highly polymorphic and their allelic distributions are different among different ethnic groups; diseases can be associated with different HLA alleles among different ethnic groups, and there is a possibility that the different HLA alleles may contribute to the difference in pathogenesis based on ethnicity.…”

Section: Introductionmentioning

confidence: 99%

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HLA-DPB1 and NFKBIL1 may confer the susceptibility to chronic thromboembolic pulmonary hypertension in the absence of deep vein thrombosis

et al. 2009

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Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by pulmonary hypertension caused by thromboembolism of the pulmonary artery. Etiology of CTEPH may be heterogeneous and is largely unknown, but genetic factors are considered to be involved in the etiology. It has been reported that deep vein thrombosis (DVT) and/or coagulation factor variants are predisposing factors to CTEPH. However, more than half of the CTEPH patients, especially the Japanese, do not have prior DVT or coagulation abnormality, suggesting that there should be other risk factors for CTEPH. Moreover, there are several reports on the association between CTEPH and human leukocyte antigen (HLA). To further clarify the HLA-linked gene(s) controlling the susceptibility to CTEPH, 160 patients (99 without DVT and 61 with DVT) and 380 healthy controls were analyzed for polymorphisms in 15 microsatellite markers and 5 genes in the HLA region. We found a strong association of HLA markers with the DVT-negative CTEPH, DPB1*0202 (odds ratio (OR)¼5.07, 95% confidence interval (CI)¼2.52-10.19, P¼0.00000075, corrected P-value (Pc)¼0.00014), IKBL-p*03 (OR¼2.33, 95% CI¼1.49-3.66, P¼0.00017, Pc¼0.033) and B*5201 (OR¼2.47, 95% CI¼1.56-3.90, P¼0.000086, Pc¼0.016), whereas no significant association was observed for the DVT-positive CTEPH. The comparison of clinical characteristics of patients stratified by the presence of susceptibility genes implied that the DPB1 gene controlled the severity of the vascular lesion, whereas the IKBL gene (NFKBIL1) was associated with a relatively mild phenotype.

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Venous Thromboembolism in the Black Population

Patel¹,

Lambie²,

Bonner³

et al. 2004

Arch Intern Med

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Clinical characteristics of acute pulmonary thromboembolism in Japan: Results of a multicenter registry in the japanese society of pulmonary embolism research

Abstract: SummaryBackground: Although the incidence of acute pulmonary thromboembolism (APTE) has been increasing in Japan, patient characteristics, management strategies, and outcome

Cited by 159 publications

References 20 publications

Dynamic MR perfusion imaging: Capability for quantitative assessment of disease extent and prediction of outcome for patients with acute pulmonary thromboembolism

Dynamic MR perfusion imaging: Capability for quantitative assessment of disease extent and prediction of outcome for patients with acute pulmonary thromboembolism

HLA-DPB1 and NFKBIL1 may confer the susceptibility to chronic thromboembolic pulmonary hypertension in the absence of deep vein thrombosis

Venous Thromboembolism in the Black Population

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