1.Pediatric multiple sclerosis is similar to adult-onset form in Asia.
Heng Thay Chong ; Patrick C.K. Li * ; Benjamin Ong ** ; Kwang Ho Lee *** ; Ching Piao Tsai **** ; Bhim S. Singhal ***** ; Naraporn Prayoonwiwat ****** ; Chong Tin Tan
Neurology Asia 2007;12(1):37-40
Pediatric-onset multiple sclerosis is underreported because of difficulty in diagnosis and assessment. In Western series, pediatric-onset disease showed significant differences from adult-onset disease with higher female preponderance, polysymptomatic in onset, frequent systemic manifestation in relapses, higher relapse rate, but less disability, and fewer lesions in brain magnetic resonance imaging. Multiple sclerosis manifests differently in Asians, yet there was no large series of pediatric-onset multiple sclerosis reported. We found that pediatric-onset disease in Asians showed greater similarity with adult-onset disease without the reported differences in female preponderance, relapse rate, and magnetic resonance imaging findings. There were also similar proportion and clinical features in optico-spinal form, and long spinal cord lesions were common in both groups. The significant difference was less disability among the pediatric-onset group. Thus, although multiple sclerosis in Asia is different from Western countries, there is greater similarity between the pediatric-onset and adult-onset group in Asia.
Multiple Sclerosis
;
Adult
;
Asia
;
Pediatric
;
Cancer Relapse
2.Registry of infl ammatory demyelinating diseases of the central nervous system in the Asia-Pacifi c region
Qi Cheng ; Allan G. Kermode ; Bhim Singhal ; Kwang Ho Lee ; Victor HT Chong ; Nguyen Thanh Binh ; Ching-Piao Tsai ; Jusuf Misbach ; Guo-Xin Jiang ; Sten Fredrikson
Neurology Asia 2012;17(1):49-54
Background and Objective: Comparable data are sparse for infl ammatory demyelinating diseases of
the central nervous system (CNS) in the Asia-Pacifi c region, and we aimed to establish a registry
of patients with such diseases in the region. Methods: A network of neurologists in the Asia-Pacifi c
Region was established to register patients with the targeted diseases. A standardized register form and
relevant instructions in English, translated into the local language when needed, were prepared before
the study start and used for data collection. Results: Eight study centres from different countries/areas
participated in the study. In total, 857 patients with a validated diagnosis of different infl ammatory
demyelinating diseases of the CNS were registered, 591 females and 266 males with a female-to-male
ratio 2.2. The mean age at onset for all patients was 35.9 (SD: 12.9) years, signifi cantly younger (p =
0.010) for females (35.1 years, SD: 12.6 years) than for males (37.6 years, SD: 13.4 years).
Conclusion: Patients with different infl ammatory demyelinating diseases of the CNS were in the fi rst
time registered in a multi-centre study from eight countries/areas in the Asia-Pacifi c region. A platform
and basis has been established for further study in the fi eld.
3.Can Elderly Patients with Severe Mitral Regurgitation Benefit from Trans-catheter Mitral Valve Repair?
Ching Wei LEE ; Shih Hsien SUNG ; Wei Ming HUANG ; Yi Lin TSAI ; Hsiang Yao CHEN ; Chiao Po HSU ; Chun Che SHIH ; Kuo Piao CHUNG
Korean Circulation Journal 2019;49(6):532-541
BACKGROUND AND OBJECTIVES: Age is a traditional risk factor for open-heart surgery. The efficacy and safety of transcatheter edge-to-edge mitral valve repair, using MitraClip (Abbott Vascular), has been demonstrated in patients with severe mitral regurgitation (MR). Since octogenarians or older patients are usually deferred to receive open-heart surgery, the main interest of this study is to elucidate the procedural safety and long-term clinical impact of MitraClip in elderly patients. METHODS: Patients with symptomatic severe MR were evaluated by the heart team. For those with high or prohibitive surgical risks, transcatheter mitral valve repair was performed in hybrid operation room. Transthoracic echocardiography (TTE), blood tests, and six-minute walk test (6MWT) were performed before, 1-month, 6-months, and 1 year after index procedure. RESULTS: A total of 46 consecutive patients receiving MitraClip procedure were enrolled. Nineteen patients (84.2±4.0 years) were over 80-year-old and 27 (73.4±11.1 years) were younger than 80. Compare to baseline, the significant reduction in MR severity was achieved after the procedure and sustained. All the patients benefited from significant improvement in New York Heart Association functional class. The 6-minute walk test (6MWT) increased from 259±114 to 319±92 meters (p=0.03) at 1 year. The overall 1-year survival rate was 80% in the elderly and 88% in those <80 years, p=0.590. Baseline 6MWT was a predictor for all-cause mortality (odds ratio, 0.99; 95% confidence interval, 0.982–0.999; p=0.026) after the MitraClip procedure. CONCLUSIONS: Trans-catheter edge-to-edge mitral valve repairs are safe and have positive clinical impact in subjects with severe MR, even in advanced age.
Aged
;
Aged, 80 and over
;
Echocardiography
;
Heart
;
Hematologic Tests
;
Humans
;
Mitral Valve Insufficiency
;
Mitral Valve
;
Mortality
;
Risk Factors
;
Survival Rate
4.Can Elderly Patients with Severe Mitral Regurgitation Benefit from Trans-catheter Mitral Valve Repair?
Ching Wei LEE ; Shih Hsien SUNG ; Wei Ming HUANG ; Yi Lin TSAI ; Hsiang Yao CHEN ; Chiao Po HSU ; Chun Che SHIH ; Kuo Piao CHUNG
Korean Circulation Journal 2019;49(6):532-541
BACKGROUND AND OBJECTIVES:
Age is a traditional risk factor for open-heart surgery. The efficacy and safety of transcatheter edge-to-edge mitral valve repair, using MitraClip (Abbott Vascular), has been demonstrated in patients with severe mitral regurgitation (MR). Since octogenarians or older patients are usually deferred to receive open-heart surgery, the main interest of this study is to elucidate the procedural safety and long-term clinical impact of MitraClip in elderly patients.
METHODS:
Patients with symptomatic severe MR were evaluated by the heart team. For those with high or prohibitive surgical risks, transcatheter mitral valve repair was performed in hybrid operation room. Transthoracic echocardiography (TTE), blood tests, and six-minute walk test (6MWT) were performed before, 1-month, 6-months, and 1 year after index procedure.
RESULTS:
A total of 46 consecutive patients receiving MitraClip procedure were enrolled. Nineteen patients (84.2±4.0 years) were over 80-year-old and 27 (73.4±11.1 years) were younger than 80. Compare to baseline, the significant reduction in MR severity was achieved after the procedure and sustained. All the patients benefited from significant improvement in New York Heart Association functional class. The 6-minute walk test (6MWT) increased from 259±114 to 319±92 meters (p=0.03) at 1 year. The overall 1-year survival rate was 80% in the elderly and 88% in those <80 years, p=0.590. Baseline 6MWT was a predictor for all-cause mortality (odds ratio, 0.99; 95% confidence interval, 0.982–0.999; p=0.026) after the MitraClip procedure.
CONCLUSIONS
Trans-catheter edge-to-edge mitral valve repairs are safe and have positive clinical impact in subjects with severe MR, even in advanced age.