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Murakami T, Watanabe Y, Nakamura N, Natsumeda M, Ohno Y, Nakazawa G, Ikari Y, Kataoka A, Nishihata Y, Hayashida K, Yamamoto M, Tanaka J, Jujo K, Izumo M, Mizutani K, Kozuma K. Clinical efficacy of tolvaptan in acute decompensated heart failure patients with severe aortic stenosis and atrial fibrillation: a sub-analysis from the LOHAS registry. Heart Vessels 2024:10.1007/s00380-024-02397-3. [PMID: 38710808 DOI: 10.1007/s00380-024-02397-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 03/13/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Severe aortic valve stenosis (AS) and atrial fibrillation (AF) are risk factors of hemodynamic instability in heart failure (HF) management due to low cardiac output, respectively. Therefore, the treatment of HF due to severe AS complicated with AF is anticipated to be difficult. Tolvaptan, a vasopressin V2 receptor inhibitor, is effective in controlling acute decompensated heart failure (ADHF) with hemodynamic stability. However, its clinical efficacy against ADHF caused by AS with AF remains to be determined. METHODS Clinical information (from September 2014 to December 2017) of 59 patients diagnosed with ADHF due to severe AS (20 patients with AF; 39 patients with sinus rhythm [SR]) was obtained from the LOHAS registry. The registry collected data from seven hospitals and assessed the short-term effects of tolvaptan in patients hospitalized for ADHF with severe AS. We attempted to identify clinical differences from baseline up to 4 days, comparing patients with AF (AF group) versus those with SR (SR group). RESULTS There were no significant differences between the groups in age (83.7 ± 4.5 vs. 85.8 ± 6.9 years, respectively; p = 0.11) and aortic valve area (0.60 [0.46-0.73] vs. 0.56 [0.37-0.70] cm2, respectively; p = 0.50). However, left atrial volume was larger (104 [85-126] vs. 87 [64-103] mL, respectively; p < 0.01), whereas stroke volume was lower (51.6 ± 14.8 vs. 59.0 ± 18.7 mL, respectively; p = 0.08) in the AF group versus the SR group. Body weight decreased daily from baseline up to day 4 in both groups (from 55.4 to 53.2 kg [p < 0.01] and from 53.5 to 51.0 kg [p < 0.01], respectively) without change in heart rate. Notably, the systolic blood pressure decreased slightly in the AF group after 2 days of treatment with tolvaptan. CONCLUSIONS Short-term treatment with tolvaptan improved HF in patients hospitalized for severe AS, regardless of the presence of AF or SR. After achieving sufficient diuresis, a slight decrease in blood pressure was observed in the AF group, suggesting an appropriate timeframe for safe and effective use of tolvaptan.
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Affiliation(s)
| | | | | | | | - Yohei Ohno
- Tokai University School of Medicine, Kanagawa, Japan
| | - Gaku Nakazawa
- Tokai University School of Medicine, Kanagawa, Japan
- Kindai University Faculty of Medicine, Osaka, Japan
| | - Yuji Ikari
- Tokai University School of Medicine, Kanagawa, Japan
| | | | | | | | | | - Jun Tanaka
- Tokyo Metropolitan Geriatric Medical Center, Tokyo, Japan
| | | | - Masaki Izumo
- St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kazuki Mizutani
- Kindai University Faculty of Medicine, Osaka, Japan
- Osaka City University School of Medicine, Osaka, Japan
| | - Ken Kozuma
- Teikyo University School of Medicine, Tokyo, Japan
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2
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Hara H, Kubo S, Nakajima Y, Matsumoto T, Kondo Y, Sugane H, Okubo K, Nakagawa K, Nagatomo D, Hachinohe D, Kusa S, Goya M, Nanasato M, Arita T, Yamasaki H, Kuwabara K, Yoshiyama T, Tanaka N, Masuda M, Sakamoto T, Nakashima M, Ohno Y, Saito S, Fukunaga M. Initial results of transcatheter modification of left atrial appendage by obliteration with device in patients with nonvalvular atrial fibrillation: Real-world data from the TERMINATOR registry. J Cardiol 2024; 83:298-305. [PMID: 37802202 DOI: 10.1016/j.jjcc.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 09/15/2023] [Accepted: 09/27/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Percutaneous left atrial appendage closure (LAAC) has increased for those who need alternative to long-term anticoagulation with non-valvular atrial fibrillation (NVAF). METHODS AND RESULTS From September 2019, after initiating WATCHMAN (Boston Scientific, Maple Grove, MN, USA) device implantation, we established Transcatheter Modification of Left Atrial Appendage by Obliteration with Device in Patients from the NVAF (TERMINATOR) registry. Utilizing 729 patients' data until January 2022, we analyzed percutaneous LAAC data regarding this real-world multicenter prospective registry. A total of 729 patients were enrolled. Average age was 74.9 years and 28.5 % were female. Paroxysmal AF was 37.9 % with average CHADS2 3.2, CHA2DS2-VASc 4.7, and HAS-BLED score of 3.4. WATCHMAN implantation was successful in 99.0 %. All-cause deaths were 3.2 %, and 1.2 % cardiovascular or unexplained deaths occurred during follow-up [median 222, interquartile range (IQR: 93-464) days]. Stroke occurred in 2.2 %, and the composite endpoint which included cardiovascular or unexplained death, stroke, and systemic embolism were counted as 3.4 % [median 221, (IQR: 93-464) days]. Major bleeding defined as BARC type 3 or 5 was seen in 3.7 %, and there was 8.6 % of all bleeding events in total [median 219, (IQR: 93-464) days]. CONCLUSIONS These preliminary data demonstrated percutaneous LAAC with WATCHMAN device might have a potential to reduce stroke and bleeding events for patients with NVAF. Further investigation is mandatory to confirm the long-term results of this strategy using this transcatheter local therapy instead of life-long systemic anticoagulation.
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Affiliation(s)
- Hidehiko Hara
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
| | - Shunsuke Kubo
- Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan
| | | | - Takashi Matsumoto
- Department of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Yusuke Kondo
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hiroki Sugane
- Division of Cardiology, Chikamori Hospital, Kochi, Japan
| | - Kenji Okubo
- Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine, Okayama University Hospital, Okayama, Japan
| | - Daisuke Nagatomo
- Division of Cardiology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Daisuke Hachinohe
- Department of Cardiovascular Medicine, Sapporo Cardio Vascular Clinic, Sapporo, Japan
| | - Shigeki Kusa
- Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - Masahiko Goya
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mamoru Nanasato
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Takeshi Arita
- Division of Cardiovascular Medicine, Fukuoka Wajiro Hospital, Fukuoka, Japan
| | - Hiro Yamasaki
- Department of Cardiology, University of Tsukuba, Tsukuba, Japan
| | - Kensuke Kuwabara
- Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Tomotaka Yoshiyama
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Nobuaki Tanaka
- Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan
| | - Masaharu Masuda
- Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan
| | - Tomohiro Sakamoto
- Cardiovascular Center Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | | | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Shigeru Saito
- Department of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Masato Fukunaga
- Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
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3
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Saito T, Inohara T, Tsuruta H, Yashima F, Shimizu H, Fukuda K, Ohno Y, Nishina H, Izumo M, Asami M, Naganuma T, Mizutani K, Yamawaki M, Tada N, Yamanaka F, Shirai S, Noguchi M, Ueno H, Takagi K, Watanabe Y, Yamamoto M, Hayashida K. Pre-Existing Left Bundle Branch Block and Clinical Outcomes After Transcatheter Aortic Valve Replacement. JACC Asia 2024; 4:306-319. [PMID: 38660100 PMCID: PMC11035950 DOI: 10.1016/j.jacasi.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/11/2023] [Accepted: 11/05/2023] [Indexed: 04/26/2024]
Abstract
Background Few reports on pre-existing left bundle branch block (LBBB) in patients undergoing transcatheter aortic valve replacement (TAVR) are currently available. Further, no present studies compare patients with new onset LBBB with those with pre-existing LBBB. Objectives This study aimed to investigate the association between pre-existing or new onset LBBB and clinical outcomes after TAVR. Methods Using data from the Japanese multicenter registry, 5,996 patients who underwent TAVR between October 2013 and December 2019 were included. Patients were classified into 3 groups: no LBBB, pre-existing LBBB, and new onset LBBB. The 2-year clinical outcomes were compared between 3 groups using Cox proportional hazards models and propensity score analysis to adjust the differences in baseline characteristics. Results Of 5,996 patients who underwent TAVR, 280 (4.6%) had pre-existing LBBB, while 1,658 (27.6%) experienced new onset LBBB. Compared with the no LBBB group, multivariable Cox regression analysis showed that pre-existing LBBB was associated not only with a higher 2-year all-cause (adjusted HR: 1.39; 95% CI: 1.06-1.82; P = 0.015) and cardiovascular (adjusted HR: 1.60; 95% CI: 1.04-2.48; P = 0.031) mortality, but also with higher all-cause (adjusted HR: 1.43, 95% CI: 1.07-1.91; P = 0.016) and cardiovascular (adjusted HR: 1.81, 95% CI:1.12-2.93; P = 0.014) mortality than the new onset LBBB group. Heart failure was the most common cause of cardiovascular death, with more heart failure deaths in the pre-existing LBBB group. Conclusions Pre-existing LBBB was independently associated with poor clinical outcomes, reflecting an increased risk of cardiovascular mortality after TAVR. Patients with pre-existing LBBB should be carefully monitored.
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Affiliation(s)
- Tetsuya Saito
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Taku Inohara
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Hikaru Tsuruta
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Fumiaki Yashima
- Department of Cardiology, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Hideyuki Shimizu
- Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Hidetaka Nishina
- Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Masaki Izumo
- Department of Cardiology, St. Marianna University, Tokyo, Japan
| | - Masahiko Asami
- Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Toru Naganuma
- Department of Cardiology, New Tokyo Hospital, Matsudo, Japan
| | | | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Tsurumi, Japan
| | - Norio Tada
- Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan
| | - Futoshi Yamanaka
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Shinichi Shirai
- Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan
| | - Masahiko Noguchi
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Hiroshi Ueno
- Department of Cardiology, Toyama University Hospital, Toyama, Japan
| | - Kensuke Takagi
- Department of Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yusuke Watanabe
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Masanori Yamamoto
- Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan
- Department of Cardiology, Nagoya Heart Center, Nagoya, Japan
- Department of Cardiology, Gifu Heart Center, Gifu, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - the OCEAN-TAVI Investigators
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
- Department of Cardiology, Saiseikai Utsunomiya Hospital, Tochigi, Japan
- Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
- Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Japan
- Department of Cardiology, St. Marianna University, Tokyo, Japan
- Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
- Department of Cardiology, New Tokyo Hospital, Matsudo, Japan
- Department of Cardiology, Kinki University, Osaka, Japan
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Tsurumi, Japan
- Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
- Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
- Department of Cardiology, Toyama University Hospital, Toyama, Japan
- Department of Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
- Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan
- Department of Cardiology, Nagoya Heart Center, Nagoya, Japan
- Department of Cardiology, Gifu Heart Center, Gifu, Japan
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4
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Imamura T, Nakai M, Iwanaga Y, Sumita Y, Tao M, Ohno Y, Hayashida K, Morino Y, Seo Y, Saiki Y, Anzai T, Toda K, Matsumiya G, Yamamoto K, Hirata K, Kinugawa K. Two-Year Clinical Outcome of MitraClip Transcatheter Edge-to-Edge Repair From the J-MITRA Registry Data. Circ J 2024; 88:539-548. [PMID: 38447968 DOI: 10.1253/circj.cj-23-0924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
BACKGROUND The introduction of transcatheter edge-to-edge repair for moderate-to-severe or severe mitral regurgitation (MR) utilizing the MitraClip system became reimbursed and clinically accessible in Japan in April 2018. This study presents the 2-year clinical outcomes of all consecutively treated patients who underwent MitraClip implantation in Japan and were prospectively enrolled in the Japanese Circulation Society-oriented J-MITRA registry.Methods and Results: Analysis encompassed 2,739 consecutive patients enrolled in the J-MITRA registry with informed consent (mean age: 78.3±9.6 years, 1,550 males, STS risk score 11.7±8.9), comprising 1,999 cases of functional MR, 644 of degenerative MR and 96 in a mixed group (DMR and FMR). The acute procedure success rate was 88.9%. After MitraClip implantation, >80% exhibited an MR grade ≤2+ and the trend was sustained over the 2 years. Within this observation period, the mortality rate was 19.3% and the rate of heart failure readmissions was 20.6%. The primary composite endpoint, inclusive of cardiovascular death and heart failure readmission, was significantly higher in patients with functional MR than in with degenerative MR (32.0% vs. 17.5%, P<0.001). CONCLUSIONS The 2-year clinical outcomes after MitraClip implantation were deduced from comprehensive data within an all-Japan registry.
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Affiliation(s)
| | - Michikazu Nakai
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center
- Clinical Research Support Center, University of Miyazaki Hospital
| | - Yoshitaka Iwanaga
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center
- Department of Cardiology, Sakurabashi-Watanabe Hospital
| | - Yoko Sumita
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center
| | - Misato Tao
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center
| | - Yohei Ohno
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine
| | | | - Yoshihiro Morino
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
| | - Yoshihiro Seo
- Department of Cardiology, Nagoya City University Graduate School of Medical Sciences
| | - Yoshikatsu Saiki
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Koichi Toda
- Department of Cardiovascular Surgery, Dokkyo Medical University Saitama Medical Center
| | - Goro Matsumiya
- Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine
| | - Kazuhiro Yamamoto
- Division of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University
| | - Kenichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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5
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Armario X, Carron J, Simpkin AJ, Elhadi M, Kennedy C, Abdel-Wahab M, Bleiziffer S, Lefèvre T, Wolf A, Pilgrim T, Villablanca PA, Blackman DJ, Van Mieghem NM, Hengstenberg C, Swaans MJ, Prendergast BD, Patterson T, Barbanti M, Webb JG, Behan M, Resar J, Chen M, Hildick-Smith D, Spence MS, Zweiker D, Bagur R, Teles R, Ribichini FL, Jagielak D, Park DW, Kornowski R, Wykrzykowska JJ, Bunc M, Estévez-Loureiro R, Poon K, Götberg M, Jeger RV, Ince H, Packer EJS, Angelillis M, Nombela-Franco L, Guo Y, Savontaus M, Al-Moghairi AM, Parasca CA, Kliger C, Roy D, Molnár L, Silva M, White J, Yamamoto M, Carrilho-Ferreira P, Toggweiler S, Voudris V, Ohno Y, Rodrigues I, Parma R, Ojeda S, Toutouzas K, Regueiro A, Grygier M, AlMerri K, Cruz-González I, Fridrich V, de la Torre Hernández JM, Noble S, Kala P, Asmarats L, Kurt IH, Bosmans J, Erglis M, Casserly I, Iskandarani D, Bhindi R, Kefer J, Yin WH, Rosseel L, Kim HS, O'Connor S, Hellig F, Sztejfman M, Mendiz O, Pineda AM, Seth A, Pllaha E, de Brito FS, Bajoras V, Balghith MA, Lee M, Eid-Lidt G, Vandeloo B, Vaz VD, Alasnag M, Ussia GP, Tay E, Mayol J, Gunasekaran S, Sardella G, Buddhari W, Kao HL, Dager A, Tzikas A, Gudmundsdottir IJ, Edris A, Gutiérrez Jaikel LA, Arias EA, Al-Hijji M, Ertürk M, Conde-Vela C, Boljević D, Ferrero Guadagnoli A, Hermlin T, ElGuindy AM, Lima-Filho MDO, de Moura Santos L, Perez L, Maluenda G, Akyüz AR, Alhaddad IA, Amin H, So CY, Al Nooryani AA, Vaca C, Albistur J, Nguyen QN, Arzamendi D, Grube E, Modine T, Tchétché D, Hayashida K, Latib A, Makkar RR, Piazza N, Søndergaard L, McEvoy JW, Mylotte D. Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study. JACC Cardiovasc Interv 2024; 17:374-387. [PMID: 38180419 DOI: 10.1016/j.jcin.2023.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND The COVID-19 pandemic adversely affected health care systems. Patients in need of transcatheter aortic valve replacement (TAVR) are especially susceptible to treatment delays. OBJECTIVES This study sought to evaluate the impact of the COVID-19 pandemic on global TAVR activity. METHODS This international registry reported monthly TAVR case volume in participating institutions prior to and during the COVID-19 pandemic (January 2018 to December 2021). Hospital-level information on public vs private, urban vs rural, and TAVR volume was collected, as was country-level information on socioeconomic status, COVID-19 incidence, and governmental public health responses. RESULTS We included 130 centers from 61 countries, including 65,980 TAVR procedures. The first and second pandemic waves were associated with a significant reduction of 15% (P < 0.001) and 7% (P < 0.001) in monthly TAVR case volume, respectively, compared with the prepandemic period. The third pandemic wave was not associated with reduced TAVR activity. A greater reduction in TAVR activity was observed in Africa (-52%; P = 0.001), Central-South America (-33%; P < 0.001), and Asia (-29%; P < 0.001). Private hospitals (P = 0.005), urban areas (P = 0.011), low-volume centers (P = 0.002), countries with lower development (P < 0.001) and economic status (P < 0.001), higher COVID-19 incidence (P < 0.001), and more stringent public health restrictions (P < 0.001) experienced a greater reduction in TAVR activity. CONCLUSIONS TAVR procedural volume declined substantially during the first and second waves of the COVID-19 pandemic, especially in Africa, Central-South America, and Asia. National socioeconomic status, COVID-19 incidence, and public health responses were associated with treatment delays. This information should inform public health policy in case of future global health crises.
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Affiliation(s)
- Xavier Armario
- Department of Cardiology, Galway University Hospital, Galway, Ireland; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jennifer Carron
- Department of Cardiology, Galway University Hospital, Galway, Ireland
| | - Andrew J Simpkin
- School of Mathematical and Statistical Sciences, University of Galway, Galway, Ireland
| | - Mohamed Elhadi
- Department of Cardiology, Galway University Hospital, Galway, Ireland
| | - Ciara Kennedy
- Department of Cardiology, Galway University Hospital, Galway, Ireland
| | | | - Sabine Bleiziffer
- Heart and Diabetes Center Northrhine-Westfalia, Clinic for Thoracic and Cardiovascular Surgery, Bad Oeynhausen, Germany
| | | | | | | | | | | | | | | | | | | | | | | | - John G Webb
- St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Miles Behan
- Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Jon Resar
- John Hopkins Hospital, Baltimore, Maryland, USA
| | - Mao Chen
- West China Hospital, Sichuan University, Chengdu, China
| | | | | | | | - Rodrigo Bagur
- University Hospital, London Health Sciences Center, London, Ontario, Canada
| | - Rui Teles
- Hospital de Santa Cruz, CHLO, Nova Medical School, CEDOC, Lisbon, Portugal
| | | | | | | | | | | | - Matjaz Bunc
- Ljubljana University Medical Center, Ljubljana, Slovenia
| | | | - Karl Poon
- The Prince Charles Hospital, Brisbane, Australia
| | - Matthias Götberg
- Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden
| | | | | | | | | | | | - Yingqiang Guo
- West China Hospital, Sichuan University, Chengdu, China
| | | | | | | | - Chad Kliger
- Lenox Hill/Northwell Health, New York, New York, USA
| | - David Roy
- St. Vincent's Hospital, Sydney, Australia
| | - Levente Molnár
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Mariana Silva
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | | | - Masanori Yamamoto
- Toyohashi Heart Center, Toyohashi, Japan; Nagoya Heart Center, Nagoya, Japan; Gifu Heart Center, Gifu, Japan
| | | | | | | | - Yohei Ohno
- Tokai University School of Medicine, Isehara, Japan
| | | | | | - Soledad Ojeda
- Hospital Universitario Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain
| | | | | | - Marek Grygier
- Poznan University School of Medical Sciences, Poznan, Poland
| | | | | | - Viliam Fridrich
- National Institute of Cardiovascular Diseases, Bratislava, Slovakia
| | | | | | - Petr Kala
- Centrum Kardiovaskulární a Transplantační Chirurgie, Brno, Czechia
| | | | | | | | | | - Ivan Casserly
- Mater Misericordiae University Hospital, Dublin, Ireland; Mater Private Hospital, Dublin, Ireland
| | | | | | - Joelle Kefer
- Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | | | - Hyo-Soo Kim
- Seoul National University Hospital, Seoul, South Korea
| | | | | | | | | | - Andres M Pineda
- University of Florida College of Medicine Jacksonville, Jacksonville, Florida, USA
| | - Ashok Seth
- Fortis Escorts Heart Institute, New Delhi, India
| | | | | | - Vilhelmas Bajoras
- Division of Cardiology and Vascular Diseases, Vilnius University Hospital Santaros Clinics, Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | - Michael Lee
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - Guering Eid-Lidt
- Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Bert Vandeloo
- Department of Cardiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Belgium
| | | | | | - Gian Paolo Ussia
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Edgar Tay
- National University Heart Center, Singapore, Singapore
| | | | | | | | | | - Hsien-Li Kao
- National Taiwan University Hospital, Taipei, Taiwan
| | | | | | | | - Ahmad Edris
- Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | | | | | - Mehmet Ertürk
- Istanbul Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | | | | | | | | | | | - Moysés de Oliveira Lima-Filho
- Hospital das Clínicas de Ribeirão Preto, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | | - Luis Perez
- Hospital Clínico Regional Guillermo Grant Benavente, Concepción, Chile
| | - Gabriel Maluenda
- Hospital San Borja Arriaran, Santiago, Chile; Clínica Alemana, Santiago, Chile
| | - Ali Rıza Akyüz
- Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Health Sciences University, Trabzon, Turkey
| | | | - Haitham Amin
- Mohammed Bin Khalifa Cardiac Center, Royal Medical Services, Awali, Bahrain
| | - Chak-Yu So
- Prince of Wales Hospital, Hong Kong, Hong Kong
| | | | - Carlos Vaca
- Instituto de Cardiología Intervencionista Cardiovida SRL, Santa Cruz, Bolivia
| | - Juan Albistur
- Hospital de Clínicas Dr Manuel Quintela, Montevideo, Uruguay
| | | | | | | | | | | | | | - Azeem Latib
- Montefiore Medical Center, Bronx, New York, USA
| | - Raj R Makkar
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Nicolo Piazza
- McGill University Health Center, Montréal, Quebec, Canada
| | | | - John William McEvoy
- Department of Cardiology, Galway University Hospital, Galway, Ireland; School of Medicine, University of Galway, Galway, Ireland
| | - Darren Mylotte
- Department of Cardiology, Galway University Hospital, Galway, Ireland; School of Medicine, University of Galway, Galway, Ireland.
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6
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Murakami T, Ohno Y, Horinouchi H, Noda S, Hashimoto K, Miyamoto J, Kamioka N, Natsumeda M, Tanaka S, Ikari Y. Vericiguat and transcatheter edge-to-edge mitral valve repair for combined post- and pre-capillary pulmonary hypertension due to left ventricular low ejection fraction and functional mitral regurgitation. J Cardiol Cases 2024; 29:78-81. [PMID: 38362582 PMCID: PMC10865131 DOI: 10.1016/j.jccase.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/06/2023] [Accepted: 10/16/2023] [Indexed: 02/17/2024] Open
Abstract
A 66-year-old female was diagnosed with combined post- and pre-capillary pulmonary hypertension due to heart failure with reduced ejection fraction (47 %) and functional mitral regurgitation [mean pulmonary arterial wedge pressure: 27 mmHg; pulmonary arterial pressure: 91/30 (56) mmHg; pulmonary vascular resistance: 12.9 Wood units; and cardiac index: 1.77 L/min/m2]. Following treatment with vericiguat (a novel oral soluble guanylate cyclase stimulator), hemodynamics improved [mean pulmonary arterial wedge pressure: 27 mmHg; pulmonary arterial pressure: 54/26 (35) mmHg; pulmonary vascular resistance: 2.2 Wood units; and cardiac index: 2.80 L/min/m2]. Therefore, transcatheter edge-to-edge repair for functional mitral regurgitation was performed. One month later, further improvement in hemodynamics was confirmed. Learning objective Vericiguat (a novel oral soluble guanylate cyclase stimulator) and transcatheter edge-to-edge mitral valve repair may improve combined post- and pre-capillary pulmonary hypertension due to low ejection fraction of the left ventricle and functional mitral regurgitation.
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Affiliation(s)
- Tsutomu Murakami
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Hitomi Horinouchi
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Satoshi Noda
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Kaho Hashimoto
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Junichi Miyamoto
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Norihiko Kamioka
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Makoto Natsumeda
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Shigemitsu Tanaka
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Yuji Ikari
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
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Imamura T, Tanaka S, Ushijima R, Fukuda N, Ueno H, Kinugawa K, Kubo S, Yamamoto M, Saji M, Asami M, Enta Y, Nakashima M, Shirai S, Izumo M, Mizuno S, Watanabe Y, Amaki M, Kodama K, Yamaguchi J, Nakajima Y, Naganuma T, Bota H, Ohno Y, Yamawaki M, Mizutani K, Otsuka T, Hayashida K. Predictive Factors of Cardiac Mortality Following TEER in Patients with Secondary Mitral Regurgitation. J Clin Med 2024; 13:851. [PMID: 38337545 PMCID: PMC10856463 DOI: 10.3390/jcm13030851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Transcatheter edge-to-edge mitral valve repair (TEER) has emerged as a viable approach to addressing substantial secondary mitral regurgitation. In the contemporary landscape where ultimate heart failure-specific therapies, such as cardiac replacement modalities, are available, prognosticating a high-risk cohort susceptible to early cardiac mortality post-TEER is pivotal for formulating an effective therapeutic regimen. Methods: Our study encompassed individuals with secondary mitral regurgitation and chronic heart failure enlisted in the multi-center (Optimized CathEter vAlvular iNtervention (OCEAN)-Mitral registry. We conducted an assessment of baseline variables associated with cardiac death within one year following TEER. Results: Amongst the 1517 patients (median age: 78 years, 899 males), 101 experienced cardiac mortality during the 1-year observation period after undergoing TEER. Notably, a history of heart failure-related admissions within the preceding year, utilization of intravenous inotropes, and elevated plasma B-type natriuretic peptide levels emerged as independent prognosticators for the primary outcome (p < 0.05 for all). Subsequently, we devised a novel risk-scoring system encompassing these variables, which significantly stratified the cumulative incidence of the 1-year primary outcome (16%, 8%, and 4%, p < 0.001). Conclusions: Our study culminated in the development of a new risk-scoring system aimed at predicting 1-year cardiac mortality post-TEER.
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Affiliation(s)
- Teruhiko Imamura
- Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan (H.U.)
| | - Shuhei Tanaka
- Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan (H.U.)
| | - Ryuichi Ushijima
- Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan (H.U.)
| | - Nobuyuki Fukuda
- Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan (H.U.)
| | - Hiroshi Ueno
- Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan (H.U.)
| | - Koichiro Kinugawa
- Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan (H.U.)
| | - Shunsuke Kubo
- Department of Cardiology, Kurashiki Central Hospital, Kurashiki 710-0052, Japan;
| | - Masanori Yamamoto
- Department of Cardiology, Toyohashi Heart Center, Toyohashi 441-8071, Japan
- Department of Cardiology, Nagoya Heart Center, Nagoya 461-0045, Japan
- Department of Cardiology, Gifu Heart Center, Gifu 500-8384, Japan
| | - Mike Saji
- Department of Cardiology, Sakakibara Heart Institute, Tokyo 183-0003, Japan
- Division of Cardiovascular Medicine, Department of Internal Medicine, Faculty of Medicine, Toho University, Tokyo 143-8540, Japan
| | - Masahiko Asami
- Division of Cardiology, Mitsui Memorial Hospital, Tokyo 101-8643, Japan
| | - Yusuke Enta
- Department of Cardiology, Sendai Kosei Hospital, Sendai 980-0873, Japan (M.N.)
| | - Masaki Nakashima
- Department of Cardiology, Sendai Kosei Hospital, Sendai 980-0873, Japan (M.N.)
| | - Shinichi Shirai
- Division of Cardiology, Kokura Memorial Hospital, Kitakyushu 802-8555, Japan
| | - Masaki Izumo
- Division of Cardiology, St. Marianna University School of Medicine Hospital, Kawasaki 216-8511, Japan
| | - Shingo Mizuno
- Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa 247-8533, Japan;
| | - Yusuke Watanabe
- Department of Cardiology, School of Medicine, Teikyo University, Tokyo 173-8606, Japan
| | - Makoto Amaki
- Department of Cardiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan;
| | - Kazuhisa Kodama
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto 861-4193, Japan
| | - Junichi Yamaguchi
- Department of Cardiology, Tokyo Woman’s Medical University, Tokyo 162-8666, Japan
| | - Yoshifumi Nakajima
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University, Iwate 028-3694, Japan
| | - Toru Naganuma
- Department of Cardiology, New Tokyo Hospital, Chiba 270-2232, Japan
| | - Hiroki Bota
- Department of Cardiology, Sapporo Higashi Tokushukai Hospital, Sapporo 065-0033, Japan
| | - Yohei Ohno
- Department of Cardiology, School of Medicine, Tokai University, Isehara 259-1193, Japan
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Kanagawa 230-0012, Japan
| | - Kazuki Mizutani
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kinki University, Osaka 577-8502, Japan
| | - Toshiaki Otsuka
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo 113-8602, Japan
| | - Kentaro Hayashida
- Department of Cardiology, School of Medicine, Keio University, Tokyo 160-8582, Japan
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Nagai T, Horinouchi H, Hashimoto K, Ijichi T, Kamioka N, Murakami T, Ohno Y, Yoshioka K, Ikari Y. Incremental Value of Global Longitudinal Strain for Confirming Heart Failure-Related Symptoms in Severe Aortic Stenosis. Am J Cardiol 2023; 209:1-7. [PMID: 37839463 DOI: 10.1016/j.amjcard.2023.09.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/13/2023] [Accepted: 09/24/2023] [Indexed: 10/17/2023]
Abstract
The indications or timing of aortic valve replacement for symptomatic aortic stenosis (AS) are based on a patient's life expectancy and symptoms. However, clinical decision-making may be difficult because symptoms are subjective and cannot be quantitatively assessed and confirmed. This study aimed to evaluate the association between heart failure (HF)-related symptoms and cardiac hemodynamic left ventricular deformations in patients with severe AS using transthoracic echocardiographic assessments of left ventricular global longitudinal strain (LV-GLS). The medical records of patients hospitalized for AS between February 2017 and September 2019 were retrospectively screened. Independent cardiologists analyzed the transthoracic echocardiographic images of a digital echocardiography database. The cohort comprised 177 hospitalized patients with severe AS and no history of HF. The subgroup with HF-related symptoms included 87 patients, whereas that without HF-related symptoms included 90 patients. In 145 patients without atrial fibrillation, the left atrial volume index (LAVI) and LV-GLS were significantly associated with HF-related symptoms (odds ratio 1.033, 95% confidence interval 1.008 to 1.059, p = 0.011 and odds ratio 1.224, 95% confidence interval 1.118 to 1.340, p <0.0001, respectively). Moreover, the combination of brain natriuretic peptide level, LAVI, and LV-GLS showed better diagnostic accuracy than the combination of brain natriuretic peptide level and LAVI (p = 0.005). However, there were no such tendencies in 32 patients with atrial fibrillation. The HF-related symptoms in patients with severe AS were strongly linked to LV-GLS. LV-GLS showed incremental value for confirming HF-related symptoms.
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Affiliation(s)
- Tomoo Nagai
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Hitomi Horinouchi
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Kaho Hashimoto
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Takeshi Ijichi
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Norihiko Kamioka
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Tsutomu Murakami
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Yohei Ohno
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Koichiro Yoshioka
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Yuji Ikari
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan
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Murakami T, Horinouchi H, Noda S, Hashimoto K, Miyamoto J, Kamioka N, Nagai T, Sakai K, Torii S, Tanaka S, Okada K, Cho Y, Urimoto G, Ito K, Nakazawa G, Ikari Y, Ohno Y. Feasibility and Outcome of Transjugular Intracardiac Echocardiography-Guided Transcatheter Aortic Valve Replacement. JACC Asia 2023; 3:925-934. [PMID: 38155789 PMCID: PMC10751646 DOI: 10.1016/j.jacasi.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/18/2023] [Accepted: 07/29/2023] [Indexed: 12/30/2023]
Abstract
Background There are limited data on the impact of intracardiac echocardiography (ICE)-guided transcatheter aortic valve replacement (TAVR) on the new permanent pacemaker implantation (PPMI) rate. Objectives This study investigated the feasibility and outcome of transjugular ICE (TJ-ICE) -guided TAVR, by visualizing the relationship between the membranous septum (MS) and the transcatheter aortic valve (TAV). Methods Among patients with severe aortic stenosis who underwent TAVR between February 2017 and June 2020, this study enrolled a total of 163 patients with TJ-ICE-guided TAVR. MS length was measured by ICE. The primary endpoint of this study was the incidence of new PPMI at 30 days. Results The mean age of the patients in this study was 84.9 ± 4.6 years, and 71.2% of the patients were female. Device success was 96.3% with TJ-ICE guidance. A TJ-ICE-related complication occurred in 1 case (0.6%). The median length of the MS was 5.8 mm (IQR: 5.0-6.9 mm). Excellent intraobserver (intraclass correlation coefficient [ICC]: 0.94; 95% CI:0.79-0.98; P < 0.001) and interobserver (ICC: 0.93; 95% CI: -0.05 to 0.98; P < 0.001) agreements were shown. The new PPMI rate was 6.7% at 30 days without a significant difference between balloon-expandable valves and self-expandable valves (3.4% vs 8.7%; P = 0.226). Patients with a TAV implantation depth less than MS length had a significantly lower incidence of new PPMI compared with patients with a TAV implantation depth greater than MS length (2.1% vs 13.4%; P = 0.005), regardless of baseline right bundle branch block presence (6.7% vs 66.7%; P = 0.004) or absence (1.2% vs 8.2%; P = 0.041). Conclusions TJ-ICE-guided TAVR demonstrated remarkable feasibility and safety. The TJ-ICE-guided final TAV position had a significant impact on the new PPMI rate. (Tokai Valve Registry; UMIN000036671).
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Affiliation(s)
- Tsutomu Murakami
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Hitomi Horinouchi
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Satoshi Noda
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Kaho Hashimoto
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Junichi Miyamoto
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Norihiko Kamioka
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Tomoo Nagai
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Katsuaki Sakai
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Sho Torii
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Shigemitsu Tanaka
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Kimiaki Okada
- Department of Cardiac Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yasunori Cho
- Department of Cardiac Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Genya Urimoto
- Department of Anesthesiology, Tokai University School of Medicine, Isehara, Japan
| | - Kenji Ito
- Department of Anesthesiology, Tokai University School of Medicine, Isehara, Japan
| | - Gaku Nakazawa
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Yuji Ikari
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
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Kawamura Y, Fujii T, Ohno Y, Yoshimachi F, Ikari Y. Embolized Infective Vegetation-Induced ST-Elevation Myocardial Infarction After Transcatheter Aortic Valve Implantation. Circ J 2023; 87:1842. [PMID: 37914281 DOI: 10.1253/circj.cj-23-0494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Affiliation(s)
- Yota Kawamura
- Division of Cardiology, Tokai University Hachioji Hospital
| | | | - Yohei Ohno
- Division of Cardiology, Tokai University School of Medicine
| | | | - Yuji Ikari
- Division of Cardiology, Tokai University School of Medicine
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11
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Horinouchi H, Nagai T, Ohno Y, Miyamoto J, Kamioka N, Murakami T, Yoshioka K, Ikari Y. Mechanisms and implications of mitral regurgitation in patients with severe aortic stenosis who received transcatheter aortic valve replacement. Echocardiography 2023; 40:1187-1195. [PMID: 37715609 DOI: 10.1111/echo.15693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/08/2023] [Indexed: 09/17/2023] Open
Abstract
INTRODUCTION This study aimed to investigate the mechanisms and clinical implications of mitral regurgitation (MR) in patients with severe aortic stenosis (AS) who received transcatheter aortic valve replacement (TAVR). METHODS We conducted retrospective echocardiographic analyses at baseline and 6 months after TAVR in 140 patients with symptomatic AS (85 ± 5 years) who underwent TAVR. We defined significant MR as ≥ moderate based on evaluation of transthoracic echocardiography (TTE). RESULTS There were 48 patients (34%) with preexisting MR at the baseline. Among measured TTE parameters, end-systolic wall stress (ESWS), mitral annulus area, and mitral valve thickening index were independent factors associated with preexisting MR (odds ratio [OR]: 1.013, 95% confidence interval [CI]: 1.005-1.021; OR: 1.740, 95% CI: 1.314-2.376; OR: 2.306, 95% CI: 1.426-3.848; respectively). Six months after TAVR, there were 34 patients with post-existing MR, A history of atrial fibrillation and ESWS after TAVR were independent factors (OR: 3.013, 95% CI: 1.208-7.556; OR: 1.013, 95% CI: 1.000-1.023; respectively). The Kaplan-Meier plot indicated that preexisting MR was a risk factor for heart failure-related events within 1 year of discharge after TAVR (p = .012). CONCLUSIONS In patients who underwent TAVR for severe AS, preexisting MR was associated with having a thickened mitral valve and large mitral annulus size induced by high ESWS. These patients may have worse prognosis after TAVR and should be closely monitored in the long term.
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Affiliation(s)
- Hitomi Horinouchi
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Isehara-shi, Kanagawa, Japan
| | - Tomoo Nagai
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Isehara-shi, Kanagawa, Japan
| | - Yohei Ohno
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Isehara-shi, Kanagawa, Japan
| | - Junichi Miyamoto
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Isehara-shi, Kanagawa, Japan
| | - Norihiko Kamioka
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Isehara-shi, Kanagawa, Japan
| | - Tsutomu Murakami
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Isehara-shi, Kanagawa, Japan
| | - Koichiro Yoshioka
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Isehara-shi, Kanagawa, Japan
| | - Yuji Ikari
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Isehara-shi, Kanagawa, Japan
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Inohara T, Otsuka T, Watanabe Y, Shirai S, Tada N, Yamanaka F, Ueno H, Ohno Y, Tabata M, Suzuyama H, Asami M, Yamawaki M, Izumo M, Yamasaki K, Nishina H, Fuku Y, Mizutani K, Yashima F, Yamamoto M, Hayashida K. Rationale and design of Non-antithrombotic Therapy After Transcatheter Aortic Valve Implantation (NAPT) Trial. Contemp Clin Trials 2023; 134:107358. [PMID: 37852534 DOI: 10.1016/j.cct.2023.107358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/05/2023] [Accepted: 10/15/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Despite the wide implementation of transcatheter aortic valve implantation (TAVI), the optimal antithrombotic therapy after TAVI has not been established yet. Owing to the accumulating evidence supporting the efficacy and safety of single antiplatelet therapy (SAPT) over dual antiplatelet therapy, the latest guideline recommends life-long SAPT. However, there is scarce evidence supporting SAPT compared with non-antithrombotic therapy. Given the vulnerability of patients undergoing TAVI in terms of high bleeding risk, the benefit of SAPT may be canceled out by its potential increased bleeding risk. STUDY DESIGN AND OBJECTIVES Non-antithrombotic Therapy After Transcatheter Aortic Valve Implantation (NAPT) Trial is a prospective, randomized controlled, open-label blinded endpoint multicenter trial conducted in Japan, testing the non-inferiority of non-antithrombotic therapy compared with aspirin monotherapy in patients who underwent TAVI and had no indications for long-term oral anticoagulation therapy (OAC). Patients who successfully underwent trans-femoral TAVI for severe aortic stenosis with either balloon-expandable or self-expandable valves are eligible for inclusion. Key exclusion criteria are (i) occurrence of perioperative complications (ii) indications of taking antithrombotic drugs for other reasons; (iii) eGFR <30 ml/min/1.73 m2 or hemodialysis or peritoneal dialysis. A total of 360 patients will be randomized (1:1) to aspirin monotherapy vs. non-antithrombotic therapy. The primary outcome is a composite of all-cause mortality, myocardial infarction, stroke, and bleeding. All bleeding events based on the Valve Academic Research Consortium 3 are included as a component of the primary outcome. CONCLUSION The NAPT trial will determine the non-inferiority of a non-antithrombotic therapy compared with aspirin monotherapy after TAVI.
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Affiliation(s)
- Taku Inohara
- Department of Cardiology, Keio University of School of Medicine, Tokyo, Japan
| | - Toshiaki Otsuka
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan; Center for Clinical Research, Nippon Medical School Hospital, Tokyo, Japan
| | - Yusuke Watanabe
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinichi Shirai
- Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Norio Tada
- Department of Cardiology, Sendai Kosei Hospital, Miyagi, Japan
| | - Futoshi Yamanaka
- Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Hiroshi Ueno
- Second Department of Internal Medicine, Toyama University Hospital, Toyama, Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University, Isehara, Japan
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Hiroto Suzuyama
- Department of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Masahiko Asami
- Department of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohamashi City Eastern Hospital, Kanagawa, Japan
| | - Masaki Izumo
- Department of Cardiology, St. Marianna University Hospital, Kanagawa, Japan
| | - Kazumasa Yamasaki
- Department of Cardiology, Sapporo Higashi Tokushukai Hospital, Hokkaido, Japan
| | - Hidetaka Nishina
- Department of Cardiology, Tsukuba Medical Center, Ibaraki, Japan
| | - Yasushi Fuku
- Department of Cardiology, Kurashiki Central Hospital, Okayama, Japan
| | - Kazuki Mizutani
- Department of Cardiology, Kindai University Hospital, Osaka, Japan
| | - Fumiaki Yashima
- Department of Cardiology, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Masanori Yamamoto
- Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan; Department of Cardiology, Gifu Heart Center, Gifu, Japan; Department of Cardiology, Nagoya Heart Center, Nagoya, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Keio University of School of Medicine, Tokyo, Japan.
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13
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Leone PP, Regazzoli D, Pagnesi M, Costa G, Teles R, Adamo M, Taramasso M, De Marco F, Mangieri A, Kargoli F, Ohno Y, Saia F, Ielasi A, Ribichini F, Maffeo D, Kim WK, Maisano F, Van Mieghem NM, Colombo A, Reimers B, Latib A. Prosthesis-patient mismatch after transcatheter implantation of contemporary balloon-expandable and self-expandable valves in small aortic annuli. Catheter Cardiovasc Interv 2023; 102:931-943. [PMID: 37668097 DOI: 10.1002/ccd.30818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/29/2023] [Accepted: 08/19/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Evidence of clinical impact of PPM after TAVI is conflicting and might vary according to the type of valve implanted. AIMS To assess the clinical impact of prosthesis-patient mismatch (PPM) after transcatheter aortic valve implantation (TAVI) with balloon-expandable (BEV) and self-expandable valves (SEV) in patients with small annuli. METHODS TAVI-SMALL 2 enrolled 628 patients in an international retrospective registry, which included patients with severe aortic stenosis and small annuli (annular perimeter <72 mm or area <400 mm2 ) treated with transfemoral TAVI at 16 high-volume centers between 2011 and 2020. Analyses were performed comparing patients with less than moderate (n = 452), moderate (n = 138), and severe PPM (n = 38). Primary endpoint was incidence of all-cause mortality. Predictors of all-cause mortality and PPM were investigated. RESULTS At a median follow-up of 380 days (interquartile range: 210-709 days), patients with severe PPM, but not moderate PPM, had an increased risk of all-cause mortality when compared with less than moderate PPM (log-rank p = 0.046). Severe PPM predicted all-cause mortality in patients with BEV (hazard ratio [HR]: 5.20, 95% confidence interval [CI]: 1.27-21.2) and intra-annular valves (IAVs, HR: 4.23, 95% CI: 1.28-14.02), and it did so with borderline significance in the overall population (HR: 2.89, 95% CI: 0.95-8.79). Supra-annular valve (SAV) implantation was the only predictor of severe PPM (odds ratio: 0.33, 95% CI: 0.13-0.83). CONCLUSIONS Patients with small aortic annuli and severe PPM after TAVI have an increased risk of all-cause mortality at early term follow-up, especially after IAV or BEV implantation. TAVI with SAV protected from severe PPM.
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Affiliation(s)
- Pier Pasquale Leone
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Damiano Regazzoli
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Matteo Pagnesi
- Department of Medical and Surgical specialties, Radiological Sciences and Public Health, Institute of Cardiology, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Giuliano Costa
- U.O.C. Cardiologia, Centro Alte Specialità e Trapianti, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
| | - Rui Teles
- Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Nova Medical School, CEDOC, Lisbon, Portugal
| | - Marianna Adamo
- Department of Medical and Surgical specialties, Radiological Sciences and Public Health, Institute of Cardiology, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Maurizio Taramasso
- HerzZentrum Hirslanden Zurich, University of Zurich, Zurich, Switzerland
| | - Federico De Marco
- Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Faraj Kargoli
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
| | - Yohei Ohno
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan
| | - Francesco Saia
- Cardiology Unit, St. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alfonso Ielasi
- Clinical and Interventional Unit, Sant'Ambrogio Cardio-Thoracic Center, Milan, Italy
| | - Flavio Ribichini
- Department of Medicine, Division of Cardiology, University of Verona, Verona, Italy
| | - Diego Maffeo
- Cardiovascular Department, Interventional Cardiology Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Won-Keun Kim
- Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
| | - Francesco Maisano
- Cardio-Thoracic-Vascular Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Nicolas M Van Mieghem
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Antonio Colombo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Bernhard Reimers
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Azeem Latib
- Division of Cardiology, Montefiore Medical Center, Bronx, New York, USA
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14
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Kubo S, Yamamoto M, Saji M, Asami M, Enta Y, Nakashima M, Shirai S, Izumo M, Mizuno S, Watanabe Y, Amaki M, Kodama K, Yamaguchi J, Nakajima Y, Naganuma T, Bota H, Ohno Y, Yamawaki M, Ueno H, Mizutani K, Adachi Y, Otsuka T, Hayashida K. One-Year Outcomes and Their Relationship to Residual Mitral Regurgitation After Transcatheter Edge-to-Edge Repair With MitraClip Device: Insights From the OCEAN-Mitral Registry. J Am Heart Assoc 2023; 12:e030747. [PMID: 37815039 PMCID: PMC10757540 DOI: 10.1161/jaha.123.030747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/18/2023] [Indexed: 10/11/2023]
Abstract
Background Limited data are available about clinical outcomes and residual mitral regurgitation (MR) after transcatheter edge-to-edge repair in the large Asian-Pacific cohort. Methods and Results From the Optimized Catheter Valvular Intervention (OCEAN-Mitral) registry, a total of 2150 patients (primary cause of 34.6%) undergoing transcatheter edge-to-edge repair were analyzed and classified into 3 groups according to the residual MR severity at discharge: MR 0+/1+, 2+, and 3+/4+. The mortality and heart failure hospitalization rates at 1 year were 12.3% and 15.0%, respectively. Both MR and symptomatic improvement were sustained at 1 year with MR ≤2+ in 94.1% of patients and New York Heart Association functional class I/II in 95.0% of patients. Compared with residual MR 0+/1+ (20.4%) at discharge, both residual MR 2+ (30.2%; P < 0.001) and 3+/4+ (32.4%; P = 0.007) were associated with the higher incidence of death or heart failure hospitalization (adjusted hazard ratio [HR], 1.59; P < 0.001, and adjusted HR, 1.73; P = 0.008). New York Heart Association class III/IV at 1 year was more common in the MR 3+/4+ group (20.0%) than in the MR 0+/1+ (4.6%; P < 0.001) and MR 2+ (6.4%; P < 0.001) groups, and the proportion of New York Heart Association class I is significantly higher in the MR 1+ group (57.8%) than in the MR 2+ group (48.3%; P = 0.02). Conclusions The OCEAN-Mitral registry demonstrated favorable clinical outcomes and sustained MR reduction at 1 year in patients undergoing transcatheter edge-to-edge repair. Both residual MR 2+ and 3+/4+ after transcatheter edge-to-edge repair at discharge were associated with worse clinical outcomes compared with residual MR 0+/1+. Registration Information https://upload.umin.ac.jp. Identifier: UMIN000023653.
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Affiliation(s)
- Shunsuke Kubo
- Department of CardiologyKurashiki Central HospitalKurashikiJapan
| | - Masanori Yamamoto
- Department of CardiologyToyohashi Heart CenterToyohashiJapan
- Department of CardiologyNagoya Heart CenterNagoyaJapan
- Department of CardiologyGifu Heart CenterGifuJapan
| | - Mike Saji
- Department of CardiologySakakibara Heart InstituteTokyoJapan
- Division of Cardiovascular Medicine, Department of Internal MedicineToho University Faculty of MedicineTokyoJapan
| | - Masahiko Asami
- Division of CardiologyMitsui Memorial HospitalTokyoJapan
| | - Yusuke Enta
- Department of CardiologySendai Kosei HospitalSendaiJapan
| | | | - Shinichi Shirai
- Division of CardiologyKokura Memorial HospitalKitakyushuJapan
| | - Masaki Izumo
- Division of CardiologySt. Marianna University School of Medicine HospitalKawasakiJapan
| | - Shingo Mizuno
- Department of CardiologyShonan Kamakura General HospitalKanagawaJapan
| | - Yusuke Watanabe
- Department of CardiologyTeikyo University School of MedicineTokyoJapan
| | - Makoto Amaki
- Department of CardiologyNational Cerebral and Cardiovascular CenterSuitaJapan
| | - Kazuhisa Kodama
- Division of CardiologySaiseikai Kumamoto Hospital Cardiovascular CenterKumamotoJapan
| | | | - Yoshifumi Nakajima
- Division of Cardiology, Department of Internal MedicineIwate Medical UniversityIwateJapan
| | - Toru Naganuma
- Department of CardiologyNew Tokyo HospitalChibaJapan
| | - Hiroki Bota
- Department of CardiologySapporo Higashi Tokushukai HospitalSapporoJapan
| | - Yohei Ohno
- Department of CardiologyTokai University School of MedicineIseharaJapan
| | - Masahiro Yamawaki
- Department of CardiologySaiseikai Yokohama City Eastern HospitalKanagawaJapan
| | - Hiroshi Ueno
- Second Department of Internal MedicineToyama University HospitalToyamaJapan
| | - Kazuki Mizutani
- Division of Cardiology, Department of MedicineKinki University Faculty of MedicineOsakaJapan
| | - Yuya Adachi
- Department of CardiologyToyohashi Heart CenterToyohashiJapan
| | - Toshiaki Otsuka
- Department of Hygiene and Public HealthNippon Medical SchoolTokyoJapan
| | - Kentaro Hayashida
- Department of CardiologyKeio University School of MedicineTokyoJapan
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15
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Hioki H, Watanabe Y, Kataoka A, Kozuma K, Shirai S, Naganuma T, Yamawaki M, Enta Y, Mizuno S, Ueno H, Ohno Y, Nakajima Y, Izumo M, Bouta H, Kodama K, Yamaguchi J, Kubo S, Amaki M, Asami M, Saji M, Mizutani K, Okazaki S, Hachinohe D, Otsuka T, Adachi Y, Yamamoto M, Hayashida K. Impact of Gender on Mortality After Transcatheter Edge-to-Edge Repair for Functional Mitral Regurgitation. Am J Cardiol 2023; 205:12-19. [PMID: 37579655 DOI: 10.1016/j.amjcard.2023.07.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/25/2023] [Accepted: 07/30/2023] [Indexed: 08/16/2023]
Abstract
Recent studies suggested short-term mortality after transcatheter edge-to-edge repair (TEER) was comparable between men and women. However, the gender-specific prognostic difference in the long-term follow-up after TEER is still unknown. To evaluate the impact of gender on long-term mortality after TEER for functional mitral regurgitation (FMR) using multicenter registry data. We retrospectively analyzed 1,233 patients (male 60.3%) who underwent TEER for FMR at 24 centers. The impact of gender on all-cause death and hospitalization for heart failure (HF) after TEER was evaluated using multivariate regression analysis and propensity score (PS) matching methods. During the 2-year follow-up, 207 all-cause death and 263 hospitalizations for HF were observed after TEER for FMR. Men had a significantly higher incidence of all-cause death than women (18.6% vs 14.1%, log-rank p = 0.03). After adjustment by multivariate Cox regression and PS matching, the male gender was significantly associated with a higher incidence of all-cause mortality after TEER than the female gender (hazard ratio 2.11, 95% confidence interval 1.42 to 3.14 in multivariate Cox regression; hazard ratio 1.89, 95% confidence interval 1.03 to 3.48 in PS matching). The gender-specific prognostic difference was even more pronounced after 1-year of TEER. On the contrary, there was no gender-related difference in hospitalization for HF after TEER. In conclusion, women with FMR had a better prognosis after TEER than men, whereas this was not observed in hospitalization for HF. This result might indicate that women with FMR are more likely to benefit from TEER.
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Affiliation(s)
- Hirofumi Hioki
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan.
| | - Yusuke Watanabe
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Akihisa Kataoka
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Ken Kozuma
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Shinichi Shirai
- Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Toru Naganuma
- Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - Yusuke Enta
- Department of Cardiovascular Center, Sendai Kosei Hospital, Sendai, Japan
| | - Shingo Mizuno
- Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanmakura, Japan
| | - Hiroshi Ueno
- Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | | | - Masaki Izumo
- Division of Cardiology, Department of Internal Medicine, St, Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroki Bouta
- Department of Cardiology, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Kazuhisa Kodama
- Department of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Junichi Yamaguchi
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Shunsuke Kubo
- Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Makoto Amaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masahiko Asami
- Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Mike Saji
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | | | - Shinya Okazaki
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo Japan
| | - Daisuke Hachinohe
- Cardiovascular Medicine, Sapporo Heart Center, Sapporo Cardio Vascular Clinic, Sapporo, Japan
| | - Toshiaki Otsuka
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
| | - Yuya Adachi
- Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan
| | - Masanori Yamamoto
- Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan; Department of Cardiology, Nagoya Heart Center, Nagoya, Japan; Department of Cardiology, Gifu Heart Center, Gifu, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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16
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Horinouchi H, Nagai T, Ohno Y, Miyamoto J, Murakami T, Kamioka N, Yoshioka K, Ikari Y. Short-term Outcomes of Urgent Transcatheter Aortic Valve Replacement in Symptomatic Aortic Stenosis That Requires Emergency Hospital Admission. Intern Med 2023; 62:2457-2463. [PMID: 36725049 PMCID: PMC10518535 DOI: 10.2169/internalmedicine.0638-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/13/2022] [Indexed: 02/03/2023] Open
Abstract
Objective This study retrospectively compared the outcomes of emergently admitted patients with aortic stenosis (AS) with or without urgent transcatheter aortic valve replacement (TAVR). Methods Patients hospitalized between February 2015 and December 2019 for symptomatic AS were retrospectively analyzed by comparing the received conservative management [continued medical therapy with or without elective surgical transcatheter replacement (SAVR) or TAVR scheduled after the index hospitalization] and urgent TAVR (TAVR during the index hospitalization). Results The cohort comprised 114 patients with symptomatic AS who required emergency admission. Urgent TAVR was performed for 37 patients, while conservative management was provided for 77 patients, including 1 who received urgent SAVR. Urgent TAVR was more likely to be performed in patients with a history of hospitalization for heart failure, high New York Heart Association class scores, a lower clinical frailty scale at admission, and a high aortic valve peak velocity (p=0.01, p<0.001, p<0.01 and p=0.02, respectively). Kaplan-Meier analyses with log-rank test revealed favorable outcomes of urgent TAVR in all-cause mortality and cardiovascular events within 60 days of admission (p<0.01, p<0.01, respectively). Conclusion Urgent TAVR had better short-term outcomes in patients with symptomatic AS who required emergency hospital admission than conservative management. When considering urgent TAVR, patients with typical heart failure symptoms due to AS with a history of heart failure hospitalization and relatively little frailty can be selected.
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Affiliation(s)
- Hitomi Horinouchi
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Japan
| | - Tomoo Nagai
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Japan
| | - Yohei Ohno
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Japan
| | - Junichi Miyamoto
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Japan
| | - Tsutomu Murakami
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Japan
| | - Norihiko Kamioka
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Japan
| | - Koichiro Yoshioka
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Japan
| | - Yuji Ikari
- Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Japan
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17
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Ohno Y, Nakatani M, Ito T, Matsui Y, Ando K, Suda Y, Ohashi K, Yokoyama S, Goto K. Activation of Lactate Receptor Positively Regulates Skeletal Muscle Mass in Mice. Physiol Res 2023; 72:465-473. [PMID: 37795889 PMCID: PMC10634564 DOI: 10.33549/physiolres.935004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/23/2023] [Indexed: 01/05/2024] Open
Abstract
G protein-coupled receptor 81 (GPR81), a selective receptor for lactate, expresses in skeletal muscle cells, but the physiological role of GPR81 in skeletal muscle has not been fully elucidated. As it has been reported that the lactate administration induces muscle hypertrophy, the stimulation of GPR81 has been suggested to mediate muscle hypertrophy. To clarify the contribution of GPR81 activation in skeletal muscle hypertrophy, in the present study, we investigated the effect of GPR81 agonist administration on skeletal muscle mass in mice. Male C57BL/6J mice were randomly divided into control group and GPR81 agonist-administered group that received oral administration of the specific GPR81 agonist 3-Chloro-5-hydroxybenzoic acid (CHBA). In both fast-twitch plantaris and slow-twitch soleus muscles of mice, the protein expression of GPR81 was observed. Oral administration of CHBA to mice significantly increased absolute muscle weight and muscle weight relative to body weight in the two muscles. Moreover, both absolute and relative muscle protein content in the two muscles were significantly increased by CHBA administration. CHBA administration also significantly upregulated the phosphorylation level of p42/44 extracellular signal-regulated kinase-1/2 (ERK1/2) and p90 ribosomal S6 kinase (p90RSK). These observations suggest that activation of GRP81 stimulates increased the mass of two types of skeletal muscle in mice in vivo. Lactate receptor GPR81 may positively affect skeletal muscle mass through activation of ERK pathway.
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Affiliation(s)
- Y Ohno
- Faculty of Rehabilitation and Care, Seijoh University, Tokai, Japan.
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18
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Asami M, Naganuma T, Ohno Y, Tani T, Okamatsu H, Mizutani K, Watanabe Y, Izumo M, Saji M, Mizuno S, Ueno H, Kubo S, Shirai S, Nakashima M, Yamamoto M, Hayashida K. Initial Japanese Multicenter Experience and Age-Related Outcomes Following Left Atrial Appendage Closure: The OCEAN-LAAC Registry. JACC Asia 2023; 3:272-284. [PMID: 37181391 PMCID: PMC10167511 DOI: 10.1016/j.jacasi.2022.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/17/2022] [Accepted: 11/07/2022] [Indexed: 05/16/2023]
Abstract
Background Limited data are available describing left atrial appendage closure (LAAC) and age-related outcomes in Asians. Objectives This study summarizes the initial experience with LAAC in Japan and determines age-related clinical outcomes in patients with nonvalvular atrial fibrillation undergoing percutaneous LAAC. Methods In an ongoing, prospective, investigator-initiated, multicenter, observational registry of patients undergoing LAAC in Japan, we analyzed short-term clinical outcomes in patients with nonvalvular atrial fibrillation who underwent LAAC. Patients were classified into younger, middle-aged, and elderly groups (≤70, 70 to 80, and >80 years of age, respectively) to determine age-related outcomes. Results Patients (n = 548; mean age, 76.4 ± 8.1 years; male, 70.3%) who underwent LAAC at 19 Japanese centers between September 2019 and June 2021 were enrolled in the study, including 104, 271, and 173 patients in the younger, middle-aged, and elderly groups, respectively. Participants had a high-risk of bleeding and thromboembolism with a mean CHADS2 score of 3.1 ± 1.3, a mean CHA2DS2-VASc score of 4.7 ± 1.5, and a mean HAS-BLED score of 3.2 ± 1.0. Device success rates were 96.5% and anticoagulants discontinuation at the 45-day follow-up was achieved in 89.9%. In-hospital outcomes were not significantly different, but major bleeding events during the 45-day follow-up were significantly higher in the elderly group compared to the other groups (younger vs middle-aged vs elderly, 1.0% vs 3.7% vs 6.9%, respectively; P = 0.047) despite the same postoperative drug regimens. Conclusions The initial Japanese experience with LAAC demonstrated safety and efficacy; however, perioperative bleeding events were more common in the elderly and postoperative drug regimens must be tailored (OCEAN-LAAC [Optimized Catheter Valvular Intervention-Left Atrial Appendage Closure] registry; UMIN000038498).
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Affiliation(s)
- Masahiko Asami
- Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Toru Naganuma
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Tomoyuki Tani
- Department of Cardiology, Sapporo East Tokushukai Hospital, Hokkaido, Japan
| | - Hideharu Okamatsu
- Department of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Kazuki Mizutani
- Department of Cardiology, Kinki University School of Medicine, Osaka, Japan
| | - Yusuke Watanabe
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Masaki Izumo
- Department of Cardiology, St Marianna University School of Medicine, Kanagawa, Japan
| | - Mike Saji
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Shingo Mizuno
- Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Hiroshi Ueno
- Department of Cardiology, Toyama University Hospital, Toyama, Japan
| | - Shunsuke Kubo
- Department of Cardiology, Kurashiki Central Hospital, Okayama, Japan
| | - Shinichi Shirai
- Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan
| | | | - Masanori Yamamoto
- Department of Cardiology, Toyohashi Heart Center, Aichi, Japan
- Department of Cardiology, Nagoya Heart Center, Aichi, Japan
- Department of Cardiology, Gifu Heart Center, Gifu, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - OCEAN-LAAC Investigators
- Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
- Department of Cardiology, Sapporo East Tokushukai Hospital, Hokkaido, Japan
- Department of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan
- Department of Cardiology, Kinki University School of Medicine, Osaka, Japan
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
- Department of Cardiology, St Marianna University School of Medicine, Kanagawa, Japan
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
- Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa, Japan
- Department of Cardiology, Toyama University Hospital, Toyama, Japan
- Department of Cardiology, Kurashiki Central Hospital, Okayama, Japan
- Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan
- Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan
- Department of Cardiology, Toyohashi Heart Center, Aichi, Japan
- Department of Cardiology, Nagoya Heart Center, Aichi, Japan
- Department of Cardiology, Gifu Heart Center, Gifu, Japan
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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19
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Inohara T, Tabata M, Isotani A, Ohno Y, Izumo M, Imamura T, Iida Y, Kataoka A, Koyama Y, Otsuka T, Watanabe Y, Yamamoto M, Hayashida K. Appropriate Use Criteria for the Management of Aortic Stenosis: Insight From the Japanese Expert Panel. JACC Asia 2023; 3:255-267. [PMID: 37181396 PMCID: PMC10167517 DOI: 10.1016/j.jacasi.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 05/16/2023]
Abstract
Background The indication for transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS) significantly varies among physicians and institutions. Objectives This study aims to develop a set of appropriate use criteria for AS management to assist physicians in decision-making. Methods The RAND-modified Delphi panel method was used. A total of >250 common clinical scenarios were identified in terms of whether to perform the intervention for AS and the mode of intervention (surgical aortic valve replacement vs TAVR). Eleven nationally representative expert panelists independently rated the clinical scenario appropriateness on a scale of 1-9, as "appropriate" (7-9), "may be appropriate" (4-6), or "rarely appropriate" (1-3); the median score of the 11 experts was then assigned to an appropriate-use category. Results The panel identified 3 factors that were associated with a rarely appropriate rating in terms of performing the intervention: 1) limited life expectancy; 2) frailty; and 3) pseudo-severe AS on dobutamine stress echocardiography. Clinical scenarios that were deemed rarely appropriate for TAVR were also identified: 1) patients with low surgical risk and high TAVR procedural risk; 2) patients with coexistent severe primary mitral regurgitation or rheumatic mitral stenosis; and 3) bicuspid aortic valve that was not suitable for TAVR. Importantly, any TAVRs for patients who were older than 75 years of age were not rated as rarely appropriate. Conclusions These appropriate use criteria provide a practical guide for physicians regarding clinical situations commonly encountered in daily practice and elucidates scenarios deemed rarely appropriate that are clinical challenges for TAVR.
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Affiliation(s)
- Taku Inohara
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Akihiro Isotani
- Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Masaki Izumo
- Department of Cardiology, St Marianna University School of Medicine, Kawasaki, Japan
| | - Teruhiko Imamura
- Second Department of Internal Medicine, University of Toyama, Toyama, Japan
| | - Yasunori Iida
- Department of Cardiovascular Surgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan
| | - Akihisa Kataoka
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Yutaka Koyama
- Department of Cardiovascular Surgery, Gifu Heart Center, Gifu, Japan
| | - Toshiaki Otsuka
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
- Center for Clinical Research, Nippon Medical School Hospital, Tokyo, Japan
| | - Yusuke Watanabe
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Masanori Yamamoto
- Department of Cardiology, Nagoya Heart Center, Aichi, Japan
- Department of Cardiology, Toyohashi Heart Center, Aichi, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - OCEAN-SHD Investigators
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
- Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
- Department of Cardiology, St Marianna University School of Medicine, Kawasaki, Japan
- Second Department of Internal Medicine, University of Toyama, Toyama, Japan
- Department of Cardiovascular Surgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
- Department of Cardiovascular Surgery, Gifu Heart Center, Gifu, Japan
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
- Center for Clinical Research, Nippon Medical School Hospital, Tokyo, Japan
- Department of Cardiology, Nagoya Heart Center, Aichi, Japan
- Department of Cardiology, Toyohashi Heart Center, Aichi, Japan
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20
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Leone PP, Regazzoli D, Pagnesi M, Cannata F, Mangieri A, Hokken TW, Costa G, Barbanti M, Teles RC, Adamo M, Taramasso M, Reifart J, De Marco F, Giannini F, Kargoli F, Ohno Y, Saia F, Buono A, Ielasi A, Pighi M, Chiarito M, Bongiovanni D, Cozzi O, Stefanini G, Ribichini FL, Maffeo D, Chizzola G, Bedogni F, Kim WK, Maisano F, Tamburino C, Van Mieghem NM, Colombo A, Reimers B, Latib A. Implantation of contemporary transcatheter aortic valves in small aortic annuli: the international multicentre TAVI-SMALL 2 registry. EUROINTERVENTION 2023:EIJ-D-22-00843. [PMID: 36950893 DOI: 10.4244/eij-d-22-00843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Treatment of aortic stenosis in patients with small annuli is challenging and can result in prosthesis-patient mismatch (PPM). AIMS We aimed to compare the forward flow haemodynamics and clinical outcomes of contemporary transcatheter valves in patients with small annuli. METHODS The TAVI-SMALL 2 international retrospective registry included 1,378 patients with severe aortic stenosis and small annuli (annular perimeter <72 mm or area <400 mm2) treated with transfemoral self-expanding (SEV; n=1,092) and balloon-expandable valves (BEV; n=286) in 16 high-volume centres between 2011 and 2020. Analyses comparing SEV versus BEV and supra-annular (SAV; n=920) versus intra-annular valves (IAV; n=458) included inverse probability of treatment weighting (IPTW). The primary endpoints were the predischarge mean aortic gradient and incidence of severe PPM. The secondary endpoint was the incidence of more than mild paravalvular leak (PVL). RESULTS The predischarge mean aortic gradient was lower after SAV versus IAV (7.8±3.9 vs 12.0±5.1; p<0.001) and SEV versus BEV implantation (8.0±4.1 vs 13.6±4.7; p<0.001). Severe PPM was more common with IAV and BEV when compared to SAV and SEV implantation, respectively, (8.8% vs 3.6%; p=0.007 and 8.7% vs 4.6%; p=0.041). At multivariable logistic regression weighted by IPTW, SAV protected from severe PPM regardless of its definition. More than mild PVL occurred more often with SEV versus BEV (11.6% vs 2.6%; p<0.001). CONCLUSIONS In small aortic annuli, implantation of SAV and SEV was associated with a more favourable forward haemodynamic profile than after IAV and BEV implantation, respectively. More than mild PVL was more common after SEV than BEV implantation.
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Affiliation(s)
- Pier Pasquale Leone
- Montefiore Medical Center, New York, NY, USA
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Damiano Regazzoli
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Matteo Pagnesi
- Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Francesco Cannata
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Antonio Mangieri
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Thijmen W Hokken
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Giuliano Costa
- U.O.C. Cardiologia, Centro Alte Specialità e Trapianti, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
| | - Marco Barbanti
- U.O.C. Cardiologia, Centro Alte Specialità e Trapianti, A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
| | - Rui Campante Teles
- Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Nova Medical School, CEDOC, Lisbon, Portugal
| | - Marianna Adamo
- Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Maurizio Taramasso
- HerzZentrum Hirslanden Zurich, Zurich, Switzerland and University of Zurich, Zurich, Switzerland
| | - Jorg Reifart
- DZHK (German Center for Cardiovascular Research), Partner Site RheinMain, Frankfurt am Main, Germany
| | - Federico De Marco
- Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | | | - Yohei Ohno
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan
| | - Francesco Saia
- Cardiology Unit, Sant'Orsola Polyclinic, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Buono
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Alfonso Ielasi
- Clinical and Interventional Unit, Sant'Ambrogio Cardio-Thoracic Center, Milan, Italy
| | - Michele Pighi
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Mauro Chiarito
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Dario Bongiovanni
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Ottavia Cozzi
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Giulio Stefanini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Flavio L Ribichini
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Diego Maffeo
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Giuliano Chizzola
- Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | | | - Won-Keun Kim
- Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
| | - Francesco Maisano
- Cardio-Thoracic-Vascular Department, IRCCS Ospedale San Raffaele, Milan, Italy.Misc
| | - Corrado Tamburino
- Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Nova Medical School, CEDOC, Lisbon, Portugal
| | - Nicolas M Van Mieghem
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Antonio Colombo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Bernhard Reimers
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Azeem Latib
- Montefiore Medical Center, New York, NY, USA
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Amino M, Kabuki S, Kunieda E, Hashimoto J, Sugawara A, Sakai T, Sakama S, Ayabe K, Ohno Y, Yagishita A, Kobayashi Y, Ikari Y, Yoshioka K. Interim Report of a Japanese Phase II Trial for Cardiac Stereotactic Body Radiotherapy in Refractory Ventricular Tachycardia - Focus on Target Determination. Circ Rep 2023; 5:69-79. [PMID: 36909137 PMCID: PMC9992511 DOI: 10.1253/circrep.cr-23-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 02/10/2023] Open
Abstract
Background: Cardiac radiotherapy using stereotactic body radiation therapy (SBRT) has attracted attention as a minimally invasive treatment for refractory ventricular tachycardia. However, a standardized protocol and software program for determining the irradiation target have not been established. Here, we report the first preclinical stereotactic radioregulation antiarrhythmic therapy trial in Japan, focused on the target-setting process. Methods and Results: From 2019 onwards, 3 patients (age range 60-91 years) presenting with ischemic or non-ischemic cardiomyopathy were enrolled. Two patients were extremely serious and urgent, and were followed up for 6 and 30 months. To determine the irradiation targets, we aggregated electrophysiological, structural, and functional data and reflected them in an American Heart Association 17-segment model, as per the current recommendations. However, in all 3 patients, invasive electrophysiological study, phase-contrast computed tomography, and magnetic resonance imaging could not be performed; therefore, electrophysiological and structural information was limited. As alternatives, high-resolution ambulatory electrocardiography and nuclear medicine studies were useful in assessing arrhythmic substrates; however, concerns regarding test weighting and multiple scoring remain. Risks to surrounding organs were fully taken into account. Conclusions: In patients requiring cardiac SBRT, the information needed for target planning is sometimes limited to minimally invasive tests. Although there are issues to be resolved, this is a promising option for the life-saving treatment of patients in critical situations.
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Affiliation(s)
- Mari Amino
- Department of Cardiology, Tokai University Isehara Japan.,National Institute for Quantum and Radiological Science and Technology Chiba Japan
| | - Shigeto Kabuki
- Department of Radiation Oncology, Tokai University Isehara Japan
| | - Etsuo Kunieda
- Department of Radiation Oncology, Tokai University Isehara Japan
| | - Jun Hashimoto
- Department of Diagnostic Radiology, Tokai University Isehara Japan
| | - Akitomo Sugawara
- Department of Radiation Oncology, Tokai University Isehara Japan
| | - Tetsuri Sakai
- Department of Cardiology, Tokai University Isehara Japan
| | - Susumu Sakama
- Department of Cardiology, Tokai University Isehara Japan
| | - Kengo Ayabe
- Department of Cardiology, Tokai University Isehara Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University Isehara Japan
| | | | | | - Yuji Ikari
- Department of Cardiology, Tokai University Isehara Japan
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22
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Leone PP, Gohar A, Pagnesi M, Mangieri A, Stefanini G, Cacia M, Cozzi O, Barbanti M, Teles R, Adamo M, Taramasso M, De Marco F, Giannini F, Ohno Y, Saia F, Buono A, Ielasi A, Pighi M, Ribichini F, Maffeo D, Bedogni F, Kim WK, Maisano F, Tamburino C, Van Mieghem NM, Colombo A, Reimers B, Latib A, Regazzoli D. Clinical outcomes in women and men with small aortic annuli undergoing transcatheter aortic valve implantation: A multicenter, retrospective, propensity score-matched comparison. Int J Cardiol 2023; 379:16-23. [PMID: 36863420 DOI: 10.1016/j.ijcard.2023.02.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/05/2023] [Accepted: 02/26/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Sex-specific characteristics in patients with aortic stenosis and small annuli undergoing transcatheter aortic valve implantation (TAVI) might affect clinical outcomes and hemodynamics. METHODS TAVI-SMALL 2 international retrospective registry included 1378 patients with severe aortic stenosis and small annuli (annular perimeter <72 mm or area < 400 mm2) treated with transfemoral TAVI at 16 high-volume centers between 2011 and 2020. Women (n = 1233) were compared with men (n = 145). One-to-one propensity score (PS) matching resulted in 99 pairs. Primary endpoint was incidence of all-cause mortality. Incidence of pre-discharge severe prosthesis-patient mismatch (PPM) and its association with all-cause mortality were investigated. Binary logistic and Cox regression were performed to adjust the treatment effect for PS quintiles. RESULTS Incidence of all-cause mortality at a median follow-up of 377 days did not differ between sex in the overall (10.3 vs. 9.8%, p = 0.842) and PS-matched (8.5 vs. 10.9%, p = 0.586) populations. After PS matching, pre-discharge severe PPM was numerically higher in women vs. men (10.2 vs. 4.3%), even though no evidence of a difference was found (p = 0.275). Within the overall population, women with severe PPM suffered a higher incidence of all-cause mortality when compared to those with less than moderate PPM (log-rank p = 0.024) and less than severe PPM (p = 0.027). CONCLUSIONS No difference in all-cause mortality at medium-term follow-up was observed between women and men with aortic stenosis and small annuli undergoing TAVI. Incidence of pre-discharge severe PPM was numerically higher in women than men, and it was associated with increased all-cause mortality in women.
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Affiliation(s)
- Pier Pasquale Leone
- Division of Cardiology, Montefiore Medical Center, Bronx, NY, USA; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Aisha Gohar
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Matteo Pagnesi
- Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical specialties, Radiological sciences and Public Health, University of Brescia, Brescia, Italy
| | - Antonio Mangieri
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giulio Stefanini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Michele Cacia
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Ottavia Cozzi
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Marco Barbanti
- U.O.C. Cardiologia, Centro Alte Specialità e Trapianti, A.O.U. Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Rui Teles
- Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Nova Medical School, CEDOC, Lisbon, Portugal
| | - Marianna Adamo
- Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical specialties, Radiological sciences and Public Health, University of Brescia, Brescia, Italy
| | - Maurizio Taramasso
- HerzZentrum Hirslanden Zurich, Switzerland and University of Zurich, Switzerland
| | - Federico De Marco
- Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Yohei Ohno
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan
| | - Francesco Saia
- Cardiology Unit, St. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andrea Buono
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Alfonso Ielasi
- Clinical and Interventional Unit, Sant'Ambrogio Cardio-Thoracic Center, Milan, Italy
| | - Michele Pighi
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Flavio Ribichini
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Diego Maffeo
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Francesco Bedogni
- Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Won-Keun Kim
- Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
| | - Francesco Maisano
- Cardio-Thoracic-Vascular Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Corrado Tamburino
- U.O.C. Cardiologia, Centro Alte Specialità e Trapianti, A.O.U. Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Nicolas M Van Mieghem
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Antonio Colombo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Bernhard Reimers
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Azeem Latib
- Division of Cardiology, Montefiore Medical Center, Bronx, NY, USA.
| | - Damiano Regazzoli
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
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23
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Sekigawa Y, Tanaka S, Suzuki D, Miyamoto J, Nakamura N, Torii S, Murakami T, Kamioka N, Ijichi T, Natsumeda M, Ohno Y, Ikari Y. Pathology of Sapien 3 After Impella-CP Insertion for Acute Coronary Syndrome With Cardiogenic Shock. Circ J 2023; 87:672. [PMID: 36823099 DOI: 10.1253/circj.cj-22-0818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Yotaro Sekigawa
- Department of Cardiology, Tokai University School of Medicine
| | | | - Daiki Suzuki
- Department of Cardiology, Tokai University School of Medicine
| | | | | | - Sho Torii
- Department of Cardiology, Tokai University School of Medicine
| | | | | | - Takeshi Ijichi
- Department of Cardiology, Tokai University School of Medicine
| | | | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine
| | - Yuji Ikari
- Department of Cardiology, Tokai University School of Medicine
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24
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Leone PP, Regazzoli D, Mangieri A, Pagnesi M, Barbanti M, Teles R, Adamo M, Taramasso M, De Marco F, Giannini F, Ohno Y, Saia F, Maffeo D, Ielasi A, Ribichini F, Kim WK, Maisano F, Tamburino C, Van Mieghem N, Colombo A, Reimers B, Latib A. CRT-700.35 Echocardiographic Transprosthetic Gradients After Implantation of Contemporary Transcatheter Valves in Patients With Small Annuli- From TAVI-SMALL 2 Registry. JACC Cardiovasc Interv 2023. [DOI: 10.1016/j.jcin.2023.01.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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25
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Miyamoto J, Ohno Y, Kamioka N, Ikari Y, Otsuka T, Tada N, Naganuma T, Yamawaki M, Yamanaka F, Shirai S, Mizutani K, Tabata M, Ueno H, Takagi K, Watanabe Y, Yamamoto M, Hayashida K. Impact of Periprocedural Pulmonary Hypertension on Outcomes After Transcatheter Aortic Valve Replacement. J Am Coll Cardiol 2022; 80:1601-1613. [DOI: 10.1016/j.jacc.2022.08.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/02/2022] [Accepted: 08/10/2022] [Indexed: 11/05/2022]
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26
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Leone PP, Regazzoli D, Mangieri A, Pagnesi M, Barbanti M, de Cruz H, Adamo M, Taramasso M, De Marco F, Giannini F, Ohno Y, Saia F, Ielasi A, Pighi M, Ribichini F, Maffeo D, Bedogni F, Kim WK, Maisano F, Tamburino C, Van Mieghem N, Colombo A, Reimers B, Latib A. TCT-323 Measured vs Predicted Effective Orifice Area-derived Prosthesis-Patient Mismatch and Clinical Outcomes in Small Aortic Annuli. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Armario X, Carron J, Abdel-Wahab M, Tchetche D, Bleiziffer S, Lefevre T, Modine T, Wolf A, Pilgrim T, Villablanca P, Cunnington M, Van Mieghem N, Hengstenberg C, Sondergaard L, Swaans M, Prendergast B, Barbanti M, Webb J, Uren N, Resar J, Chen M, Hildick-Smith D, Spence M, Zweiker D, Bagur R, de Cruz H, Ribichini F, Park DW, Codner P, Wykrzykowska J, Bunc M, Estevez-Loureiro R, Poon K, Götberg M, Ince H, Latib A, Packer E, Angelillis M, Kobari Y, Nombela-Franco L, Guo Y, Savontaus M, Arafat AA, Kliger C, Roy D, Merkely B, Silva M, White J, Yamamoto M, Ferreira PC, Toggweiler S, Ohno Y, Rodrigues I, Ojeda S, Voudris V, Grygier M, Almerri K, Cruz-Gonzalez I, Fridrich V, De la Torre Hernandez J, Piazza N, Noble S, Arzamendi D, İbrahim halil Kurt, Bosmans J, Erglis M, Casserly I, Sawaya F, Bhindi R, Kefer J, Yin WH, Rosseel L, Kim HS, O'Connor S, Hellig F, Sztejfman M, Mendiz O, Xuereb R, Brito Jr F, Bajoras V, Balghith M, Kang-Yin Lee M, Eid-Lidt G, Vandeloo B, Vaz V, Alasnag M, Ussia GP, Mayol J, Sardella G, Buddhari W, Kao HL, Dager A, Tzikas A, Edris A, Gutierrez L, Arias E, Erturk M, Conde Vela CN, Boljevic D, Guadagnoli AF, ElGuindy A, Santos L, Perez L, Maluenda G, Akyüz AR, Alhaddad I, Amin H, Yu SC, Alnooryani A, Albistur J, Nguyen Q, Mylotte D. TCT-549 Impact of COVID-19 Pandemic on TAVR Activity: A Worldwide Registry. J Am Coll Cardiol 2022. [PMCID: PMC9467506 DOI: 10.1016/j.jacc.2022.08.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Leone PP, Regazzoli D, Cannata F, Pagnesi M, Barbanti M, de Cruz H, Adamo M, Taramasso M, De Marco F, Mangieri A, Giannini F, Ohno Y, Saia F, Ielasi A, Pighi M, Ribichini F, Maffeo D, Stefanini G, Bedogni F, Kim WK, Maisano F, Tamburino C, Van Mieghem N, Colombo A, Reimers B, Latib A. TCT-500 Prosthesis–Patient Mismatch After Transcatheter Implantation of Contemporary Balloon-Expandable and Self-Expandable Valves in Small Aortic Annuli. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Watanabe Y, Hayashida K, Yamamoto M, Yamanaka F, Yamasaki K, Naganuma T, Ohno Y, Yamawaki M, Morioka N, Mizutani K, Tada N, Ueno H, Nishina H, Izumo M, Nakajima Y, Ando K, Takagi K, Kimura T, Sugio K, Dangas G, Van Mieghem NM, Hengstenberg C, Chen C, Jin J, Unverdorben M, Saito S. Edoxaban vs. Vitamin K Antagonist for Atrial Fibrillation After Transcatheter Aortic Valve Replacement in Japanese Patients ― A Subanalysis of the ENVISAGE-TAVI AF Trial ―. Circ J 2022; 86:1756-1763. [DOI: 10.1253/circj.cj-22-0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Kazuki Mizutani
- Department of Cardiovascular Medicine, Osaka City University Hospital
| | - Norio Tada
- Department of Cardiology, Sendai Kousei Hospital
| | - Hiroshi Ueno
- Department of Cardiology, Toyama University Hospital
| | | | - Masaki Izumo
- Division of Cardiology, St. Marianna University School of Medicine Hospital
| | | | - Kenji Ando
- Department of Cardiology, Kokura Memorial Hospital
| | | | | | | | - George Dangas
- Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Hospital
| | | | | | | | | | | | - Shigeru Saito
- Division of Cardiology & Catheterization Laboratories, Shonan Kamakura General Hospital
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Tsushima T, Main A, Al-Kindi SG, Dallan LAP, Wheat HL, Baeza CR, Pelletier MP, Arruda MS, Mackall JA, Thal SG, Ohno Y, Lee KH, Siqueira DA, Kaneko T, Harloff MT, Costa G, Barbanti M, Attizzani GF. Risk Stratification of New Persistent Left Bundle Branch Block After Transcatheter Aortic Valve Implantation. Am J Cardiol 2022; 175:80-87. [PMID: 35597627 DOI: 10.1016/j.amjcard.2022.03.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 11/15/2022]
Abstract
Previous studies reported that new-onset persistent left bundle branch block (NOP-LBBB) was related to worse outcomes after transcatheter aortic valve implantation (TAVI). However, these results can be confounded by the presence of permanent pacemaker (PPM) implantation before and after TAVI. Long-term outcomes and the risk stratification of NOP-LBBB not having PPM implantation before and after TAVI have not been fully investigated. This is an international, multicenter, retrospective study of patients who underwent TAVI from July 31, 2007, to May 8, 2020. A total of 2,240 patients were included, and 17.5% of patients developed NOP-LBBB. NOP-LBBB was associated with cardiac mortality (adjusted hazard ratio [aHR] 1.419, 95% confidence interval [CI] 1.014 to 1.985, p = 0.041) and the composite outcomes of cardiac mortality and/or heart failure readmission (aHR 1.313, 95% CI 1.027 to 1.678, p = 0.030). Patients who developed NOP-LBBB with pre-TAVI left ventricular ejection fraction (LVEF) <40% were significantly associated with cardiac mortality (aHR 2.049, 95% CI 1.039 to 4.041, p = 0.038), heart failure (aHR 3.990, 95% CI 2.362 to 6.741, p <0.001), and the composite outcome (aHR 2.729, 95% CI 1.703 to 4.374, p <0.001). Although NOP-LBBB with pre-TAVI LVEF >40% had a significant decrease in LVEF 6 to 12 months after TAVI (-1.8 ± 9.7% vs +0.6 ± 8.1%, p = 0.003), NOP-LBBB with pre-TAVI LVEF <40% had a significant increase in LVEF 6 to 12 months after TAVI (+9.7 ± 13.6% vs +13.0 ± 11.7%, p = 0.157). In conclusion, patients with NOP-LBBB without pre-TAVI and post-TAVI PPM developed significantly worse long-term outcomes, especially in patients with pre-TAVI LVEF <40%. Further prospective investigation should be undertaken.
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Affiliation(s)
- Takahiro Tsushima
- Department of Medicine, Division of Cardiology, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Anthony Main
- Department of Medicine, Division of Cardiology, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Sadeer G Al-Kindi
- Department of Medicine, Division of Cardiology, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Luis Augusto Palma Dallan
- Department of Medicine, Division of Cardiology, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Heather L Wheat
- Department of Medicine, Division of Cardiology, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Cristian R Baeza
- Department of Surgery, Division of Cardiac Surgery, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Marc P Pelletier
- Department of Surgery, Division of Cardiac Surgery, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Mauricio S Arruda
- Department of Medicine, Division of Cardiology, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Judith A Mackall
- Department of Medicine, Division of Cardiology, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Sergio G Thal
- Department of Medicine, Division of Cardiology, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Kyong-Hee Lee
- Department of Cardiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Dimytri A Siqueira
- Department of Cardiology, Instituto Dante Pazzanese de Cardiologia - Fundação Adib Jatene, Sao Paulo, Brazil
| | - Tsuyoshi Kaneko
- Department of Surgery, Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Morgan T Harloff
- Department of Surgery, Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Giuliano Costa
- Division of Cardiology, Policlinico "G. Rodolico-San Marco," University of Catania, Catania, Italy
| | - Marco Barbanti
- Division of Cardiology, Policlinico "G. Rodolico-San Marco," University of Catania, Catania, Italy
| | - Guilherme F Attizzani
- Department of Medicine, Division of Cardiology, University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio.
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Leone PP, Regazzoli D, Cannata F, Pagnesi M, Barbanti M, Teles R, Taramasso M, Mangieri A, Ohno Y, Saia F, Buono A, Ielasi A, Pighi M, Stefanini G, Ribichini F, Maffeo D, Bedogni F, Kim WK, Maisano F, Curello S, Tamburino C, Van Mieghem N, Colombo A, Reimers B, Latib A. Implantation of Contemporary Transcatheter Aortic Valves in Small Aortic Annuli: The International Multicenter TAVI-SMALL 2 Registry. Cardiovascular Revascularization Medicine 2022. [DOI: 10.1016/j.carrev.2022.06.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tsushima T, Main A, Al-Kindi SG, Dallan LAP, Wheat H, Baeza CR, Pelletier MP, Arruda M, Mackall JA, Thal S, Ohno Y, Lee KH, Siqueira DA, Kaneko T, Harloff M, Costa G, Barbanti M, Attizzani G. LONG-TERM OUTCOMES OF POST-TAVR TRANSIENT LEFT BUNDLE BRANCH BLOCK: INSIGHTS FROM A MULTICENTER INTERNATIONAL STUDY. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01702-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tsushima T, Main A, Al-Kindi SG, Dallan LAP, Wheat H, Baeza C, Pelletier M, Arruda M, Mackall JA, Thal S, Ohno Y, Lee KH, Siqueira DA, Kaneko T, Harloff M, Costa G, Barbanti M, Attizzani G. RISK STRATIFICATION OF POST-TAVR NEW LBBB OUTCOMES: INSIGHTS FROM A MULTICENTER INTERNATIONAL STUDY. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01731-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Leone PP, Regazzoli D, Cannata F, Pagnesi M, Barbanti M, Teles R, Taramasso M, Mangieri A, Ohno Y, Saia F, Buono A, Ielasi A, Pighi M, Stefanini G, Ribichini F, Maffeo D, Bedogni F, Kim WK, Maisano F, Curello S, Tamburino C, Van Mieghem N, Colombo A, Reimers B, Latib A. CRT-700.31 Implantation of Contemporary Transcatheter Aortic Valves in Small Aortic Annuli: The International Multicenter TAVI-SMALL 2 Registry. JACC Cardiovasc Interv 2022. [DOI: 10.1016/j.jcin.2022.01.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lee KH, Yagishita A, Ohno Y, Sakai T, Sakai K, Miyamoto J, Horinouchi H, Sakama S, Kamioka N, Murakami T, Ayabe K, Amino M, Yoshioka K, Ikari Y. Late-onset atrioventricular block after transcatheter aortic valve replacement. Heart Rhythm O2 2022; 2:607-613. [PMID: 34988505 PMCID: PMC8703188 DOI: 10.1016/j.hroo.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Conduction disturbances leading to permanent pacemaker implantation (PPI) rarely occur late after transcatheter aortic valve replacement (TAVR). The clinical features of this phenomenon and its association with periprocedural conduction disturbances remain uncertain. Objectives We aimed to determine the incidence and characteristics of late-onset atrioventricular block (AVB) after TAVR. Methods This single-center study included 246 patients undergoing TAVR. Late-onset AVB was defined as AVB ≥1 month after the TAVR. Results Periprocedural AVB (periAVB) occurred in 43 patients (17%). Patients with periAVB had a higher rate of right bundle branch block (47% vs 7%, P < .0001). Of the 43 patients with periAVB, 15 underwent PPI (35%) at a median duration of 6 days, whereas 1 of the remaining 203 patients without periAVB underwent PPI within 1 month (0.5%). During a median follow-up duration of 365 days, late-onset AVB occurred in 10 of 230 patients without PPI within 1 month (4%) at a median duration of 76 days. All 10 patients presented transient periprocedural atrioventricular conduction disturbances, including 8 patients with periAVB (80%), all of whom recovered within 1 month, and 9 patients underwent self-expanding valve implantation (90%). The mortality rate in patients with PPI within 1 month was higher than in those without, although the difference was not statistically significant (hazard ratio 2.68, 95% confidence interval 0.97–9.05, log-rank P = .09). Conclusion Late-onset AVB occurred in a minority of patients undergoing TAVR. Greater vigilance is warranted, particularly in patients with transient conduction disturbances during the periprocedural period following self-expanding valve implantation.
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Affiliation(s)
| | - Atsuhiko Yagishita
- Address reprint requests and correspondence: Dr Atsuhiko Yagishita, Department of Cardiology, Tokai University, Shimokasuya 143, Isehara, Kanagawa, Japan.
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Leone PP, Regazzoli D, Cannata F, Pagnesi M, Chiarito M, Barbanti M, Teles R, Adamo M, Miura M, Taramasso M, Stefanini G, Mangieri A, Kargoli F, Ohno Y, Saia F, Buono A, Ielasi A, Ribichini F, Maffeo D, Bedogni F, Kim WK, Maisano F, Curello S, Tamburino C, Van Mieghem N, Colombo A, Reimers B, Latib A. 464 Implantation of contemporary transcatheter aortic valves in small aortic annuli: the international multicentre TAVI-SMALL 2 registry. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab147.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aims
In patients with severe aortic stenosis, trans-prosthetic haemodynamics after transcatheter aortic valve implantation (TAVI) tend to be more favourable than after surgical aortic valve replacement, especially after self-expandable valve (SEV) implantation. The relative performance of TAVI according to leaflet position, that is supra-annular and intra-annular valves (SAV and IAV, respectively), has not been investigated thoroughly. Moreover, prosthesis-patient mismatch (PPM) is more common in patients with small aortic annuli, even though its clinical impact after TAVI is debated. Compare haemodynamics and clinical outcomes of transcatheter SAV and IAV in patients with small annuli.
Methods
TAVI SMALL 2 is an international retrospective registry of 1378 patients with severe aortic stenosis and small annuli (annular perimeter <72 mm or area <400 mm2 on computed tomography) treated with transfemoral transcatheter SEV (Evolut R/Pro, n = 750, Acurate Neo, n = 170 and Portico n = 172) and balloon-expandable valves (BEV, Sapien 3, n = 286) in 16 high-volume centres. Analyses were performed according to mechanism of valve release, that is SEV (n = 1092) vs. BEV (n = 286), and according to leaflet position, that is SAV (Evolut R/Pro and Acurate Neo, n = 920) vs. IAV (Sapien 3 and Portico, n = 458). Primary endpoints were pre-discharge mean aortic gradient and incidence of severe PPM. Secondary endpoint was incidence of all-cause mortality.
Results
Pre-discharge mean aortic gradient was lower both after SAV vs. IAV (7.8 ± 3.9 vs. 12.0 ± 5.1, P <0.001) and SEV vs. BEV implantation (8.0 ± 4.1 vs. 13.6 ± 4.7, P<0.001). IAV implantation was more often complicated by severe PPM when compared to SAV implantation (8.8% vs. 3.6%, P = 0.007), and severe PPM was more common after BEV than after SEV implantation (8.7% vs. 4.6%, P = 0.041). At a median follow-up of 377 days (interquartile range 168–700 days), all-cause mortality occurred in 11.9% of patients after IAV and 9.4% after SAV implantation (P = 0.172), and in 12.3% and 9.8% of BEV and SEV groups, respectively (P = 0.218). Results were confirmed at Kaplan-Meier analysis (log-rank P = 0.748 and 0.687 for SAV vs. IAV and SEV vs. BEV, respectively, Figure 1). Pre-discharge more than mild paravalvular leak (PVL) was more common with SEV than BEV (11.6% vs. 2.6%, P <0.001), while incidence of more than moderate PVL was higher both after SAV vs. IAV (1.5% vs. 0.2%, P = 0.043) and SEV vs. BEV implantation (1.4% vs. 0%, P = 0.052). New permanent pacemaker implantation was higher after SEV than BEV (13.5% vs. 8.1%, P = 0.013).
Conclusions
In this high-numerosity registry of patients with small aortic annuli, TAVI with SAV and SEV yielded a more favourable forward haemodynamic profile than after IAV and BEV implantation, respectively. All-cause mortality did not differ between groups.
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Affiliation(s)
| | - Damiano Regazzoli
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Francesco Cannata
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Matteo Pagnesi
- Cardiothoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy
| | - Mauro Chiarito
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Marco Barbanti
- UOC Cardiologia, Centro Alte Specialita’ E Trapianti, Pog Rodolico, Aou Policlinico Vittorio Emanuele, Universita’ Di Catania, Catania, Italy
| | - Rui Teles
- Centro Hospitalar De Lisboa Ocidental, Hospital De Santa Cruz, Lisbon, Portugal
| | - Marianna Adamo
- Civil Hospital and University Of Brescia, Brescia, Italy
| | - Mizuki Miura
- Cardiac Surgery, University of Zürich, Zürich, Switzerland
| | | | - Giulio Stefanini
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | | | - Faraj Kargoli
- Division of Cardiology, Montefiore Medical Center, Bronx, NY, USA
| | - Yohei Ohno
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan
| | - Francesco Saia
- Cardiology Unit, St. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Andrea Buono
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Alfonso Ielasi
- Clinical and Interventional Cardiology, Sant’ambrogio Cardio-Thoracic Center, Milan, Italy
| | - Flavio Ribichini
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Diego Maffeo
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Francesco Bedogni
- Department of Cardiology, Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Won-keun Kim
- Department of Cardiology and Cardiac Surgery, Kerckhoff Heart and Lung Center, Bad Nauheim, Germany
| | | | | | - Corrado Tamburino
- UOC Cardiologia, Centro Alte Specialita’ E Trapianti, Pog Rodolico, Aou Policlinico Vittorio Emanuele, Universita’ Di Catania, Catania, Italy
| | - Nicolas Van Mieghem
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Antonio Colombo
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
- GVM Care and Research, Maria Cecilia Hospital, Ravenna, Italy
| | - Bernhard Reimers
- Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Azeem Latib
- Division of Cardiology, Montefiore Medical Center, Bronx, NY, USA
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Mizuno Y, Norimatsu Y, Ohno Y. Achenbach syndrome in an older man. Clin Exp Dermatol 2021; 47:768-769. [PMID: 34856004 DOI: 10.1111/ced.15042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/20/2021] [Accepted: 11/29/2021] [Indexed: 12/21/2022]
Abstract
Dermatologists should consider Achenbach syndrome in the differential diagnosis for patients with purpura on the fingers. The patient should be monitored following appropriate examination and invasive tests, such as skin biopsy or angiography, should be avoided unless necessary.
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Affiliation(s)
- Y Mizuno
- Department of Dermatology, JR Tokyo General Hospital, Tokyo, Japan.,Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Y Norimatsu
- Department of Dermatology, JR Tokyo General Hospital, Tokyo, Japan.,Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Y Ohno
- Department of Dermatology, JR Tokyo General Hospital, Tokyo, Japan
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Matsumoto S, Ohno Y, Miyamoto J, Ikari Y, Tada N, Naganuma T, Yamawaki M, Yamanaka F, Shirai S, Mizutani K, Tabata M, Ueno H, Takagi K, Watanabe Y, Yamamoto M, Hayashida K. Impact of diabetes mellitus on outcome after transcatheter aortic valve replacement: Identifying high-risk diabetic population from the OCEAN-TAVI registry. Catheter Cardiovasc Interv 2021; 98:E1058-E1065. [PMID: 34611993 DOI: 10.1002/ccd.29960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/24/2021] [Accepted: 09/16/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To identify the vulnerable diabetic cohort in patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUNDS Considerable controversy remains about whether specific cohort exists in which presence of diabetes mellitus (DM) carries adverse risk of mortality after TAVR. METHODS Of the 2588 patients who were enrolled in the OCEAN-TAVI registry, 2526 patients with glycohemoglobin data were analyzed. The individuals were divided into DM and non-DM groups according to previous medical history of DM or using diabetic medicine, and increased HbA1c values (≥6.5%) at baseline. The primary endpoint of this study was 2-year all-cause mortality after TAVR. RESULTS The follow up rate of clinical outcome at 1-year was 2514/2526 (99.5%) and median follow-up period was 22.5 months. DM group had 699 (27.7%) patients, in which 153 (21.9%) was diagnosed by increased HbA1c levels without previous medical history of DM. Kaplan-Meier curve of 2-year all-cause mortality presented significant difference between patients with and without DM (p = 0.029). In addition, patients with low-density lipoprotein cholesterol (LDL-C) levels > 100 mg/dl and left ventricular ejection fraction (LVEF) < 40% had great risk of mortality after TAVR (LDL-C: hazard ratio [HR] 1.82, p < 0.001; LVEF: HR 2.61, p = 0.002, respectively). CONCLUSIONS Presence of DM was significantly associated with poor outcome after TAVR and adverse effect of DM was remarkable in patients with relatively higher LDL-C levels and reduced LVEF under 40%. These subtypes may need intensive control of cardiovascular risk factors, including DM, before and after TAVR.
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Affiliation(s)
- Shingo Matsumoto
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Junichi Miyamoto
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Yuji Ikari
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Norio Tada
- Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan
| | - Toru Naganuma
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - Futoshi Yamanaka
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Shinichi Shirai
- Division of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Kazuki Mizutani
- Division of Cardiology, Kindai University, Osakasayama, Japan
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center, Chiba, Japan
| | - Hiroshi Ueno
- Department of Cardiology, Toyama University Hospital, Toyama, Japan
| | - Kensuke Takagi
- Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan
| | - Yusuke Watanabe
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | | | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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Shimomura K, Minatogawa H, Mashiko T, Arioka H, Iihara H, Sugawara M, Hida N, Akiyama K, Nawata S, Tsuboya A, Mishima K, Izawa N, Miyaji T, Honda K, Inada Y, Ohno Y, Katada C, Morita H, Yamaguchi T, Nakajima T. LBA63 Placebo-controlled, double-blinded phase Ⅲ study comparing dexamethasone on day 1 with dexamethasone on days 1 to 4, with combined neurokinin-1 receptor antagonist, palonosetron, and olanzapine in patients receiving cisplatin-containing highly emetogenic chemotherapy: SPARED trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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40
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Fujita Y, Iihara H, Shimokawa M, Sakai C, Ikemura S, Hirose C, Kotake M, Funaguchi N, Gomyo T, Imai H, Hakamata J, Kaito D, Minato K, Arai T, Kawazoe H, Suzuki A, Ohno Y, Okura H. 1673P Efficacy and safety of 5 mg olanzapine for the prevention of carboplatin-induced nausea and vomiting in patients with thoracic malignancies: A prospective multicenter phase II study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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41
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Cho H, Kishikawa T, Tokita Y, Suzuki M, Takemoto N, Hanamoto A, Fukusumi T, Yamamoto M, Fujii M, Ohno Y, Inohara H. Corrigendum to "Prevalence of human papillomavirus in oral gargles and tonsillar washings" [Oral Oncol. 105 (2020) 104669]. Oral Oncol 2021; 120:105478. [PMID: 34366245 DOI: 10.1016/j.oraloncology.2021.105478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- H Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - T Kishikawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Y Tokita
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan; Department of Nursing, Kyoto Tachibana University, Kyoto, Japan.
| | - M Suzuki
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - N Takemoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - A Hanamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - T Fukusumi
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - M Yamamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - M Fujii
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Y Ohno
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan.
| | - H Inohara
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
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Sakai K, Ohno Y, Miyamoto J, Horinouchi H, Murakami T, Okada K, Cho Y, Ito K, Nakazawa G, Ikari Y. Optimizing self-expandable transcatheter heart valve sizing in patients with small sinus of Valsalva. Catheter Cardiovasc Interv 2021; 97:E168-E171. [PMID: 32533884 DOI: 10.1002/ccd.28988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 05/06/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To evaluate the feasibility and efficacy of transcatheter aortic valve replacement (TAVR) in patients with small sinus of Valsalva (SOV). BACKGROUND Patients with small SOV are considered unfavorable for TAVR since it carries risk of coronary obstruction after valve implantation. Therefore, these patients with small SOV were excluded from previous clinical trials. METHODS Between February 2017 and February 2019, a total of 139 consecutive patients with severe aortic stenosis (AS) undergoing TAVR were prospectively enrolled in the Tokai Valve Registry. Patients with small SOV who were treated with smaller size of self-expandable transcatheter heart valve (THV) than expected by perimeter-based sizing were included in this study. Eleven patients (7.9%) were included. RESULTS Mean age was 86.5 ± 3.8 years and median STS Score was 8.5% (interquartile range: 6.3-12.3%). Device success was accomplished in all patients and no coronary obstruction was observed. No moderate/severe paravalvular leakage, new onset conduction disturbance, and new permanent pacemaker implantation were noted. At 30-day follow-up, mean aortic valve gradient was 6.9 ± 1.7 mmHg and mean indexed aortic valve area was 0.95 ± 0.16 cm2 /m2 . Prosthetic valve performance was stable at 12-month follow-up. No severe prosthesis patient mismatch was documented at any time point. No in-hospital, 30-day, and 12-month mortality were observed. The median follow-up was 711 days (IQR: 547-803 days), and no patient was lost to follow-up. CONCLUSIONS Our preliminary experience suggests favorable safety and efficacy of TAVR utilizing self-expandable THV with intentional down-sizing in patients with severe AS and small SOV in a mid-term follow-up.
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Affiliation(s)
- Katsuaki Sakai
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Junichi Miyamoto
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Hitomi Horinouchi
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Tsutomu Murakami
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Kimiaki Okada
- Department of Cardiovascular Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yasunori Cho
- Department of Cardiovascular Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Kenji Ito
- Department of Anesthesiology, Tokai University School of Medicine, Isehara, Japan
| | - Gaku Nakazawa
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Yuji Ikari
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
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Murakami T, Ohno Y, Nakazawa G, Ikari Y. Transjugular intracardiac echocardiography-guided transcatheter aortic valve implantation. Eur Heart J 2020; 41:4071. [PMID: 32285091 DOI: 10.1093/eurheartj/ehaa224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tsutomu Murakami
- Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Gaku Nakazawa
- Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Yuji Ikari
- Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
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Ono T, Miyoshi T, Ohno Y, Ueki Y, Kuroda K, Kawamura K, Tokioka K, Ohe T, Kawai Y. Cardio-ankle vascular index as an arterial stiffness marker improves on cardiovascular events by adding to framingham risk score. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The cardio-ankle vascular index (CAVI) is a non-invasive measurement that evaluates arterial stiffness using the analysis of oscillometric waveform during cuff-Inflation. Several studies reported that CAVI is associated with cardiovascular risk factors, while the clinical prognostic value of CAVI as a surrogate marker of atherosclerosis has not been fully elucidated. Meanwhile, the Framingham risk score (FRS) is an established marker of cardiovascular outcomes.
Purpose
To investigate whether adding CAVI to Framingham risk score improves the prediction of cardiovascular events.
Methods
This prospective observational study included consecutive 422 patients with cardiovascular risk factors but without known coronary artery disease (69±8 years, 63% men). CAVI was measured by the oscillometric method with VaSera vascular screening system. Patients with atrial fibrillation, left ventricular ejection fraction <50%, both ABI<0.9, severe valvular diseases, or hemodialysis were excluded. Primacy outcomes were cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure and revascularization.
Results
During a median follow-up of 3.1 years, cardiovascular events occurred in 12.8% (3.3%, 15.7%, and 19.1% in the low, intermediate and high-risk group of stratification by FRS, respectively). The ROC curve analysis for discriminating cardiovascular events showed that the AUC of CAVI added to Framingham risk score was the highest compared to Framingham risk score and CAVI alone (CAVI added to Framingham risk score: AUC 66.9, 95% CI 59.6–74.2, Framingham risk score alone: AUC 61.5, 95% CI 53.8–69.1, CAVI alone: AUC 62.3, 95% CI 54.1–70.6). The logistic regression analysis demonstrated that CAVI and Framingham risk score were independent predictors of cardiovascular events (CAVI: OR 1.381, 95% CI 1.164–1.597, p=0.004, Framingham risk score: OR 1.135, 95% CI 1.044–1.225, p=0.007). Next, when logistic regression analysis was performed simultaneously on Framingham risk factor and CAVI, CAVI was an independent predictor of cardiovascular events (OR 1.347, 95% CI 1.124–1.569, p=0.009). Furthermore, in the likelihood ratio test, CAVI added to Framingham risk score significantly improved the cardiovascular event prediction ability than Framingham risk factor alone. Next, when patients with intermediate risk (n=217) were divided into two groups based on CAVI of 9.0, the Kaplan-Meier estimate showed that events occurred more frequently in higher CAVI group (9.3% and 29.1%, log-rank, P=0.009) and the C-statistic was 0.662. Multiple Cox analysis showed that, in the intermediate risk group, CAVI was an independent predictor of primary outcomes (HR 1.387 per 1 index, 95% CI 1.081–1.779, p=0.010).
Conclusion
The measurement of CAVI could be a useful predictor for cardiovascular events. In addition, the combination of CAVI and Framingham risk score could improve the predictability compared to the Framingham risk score alone.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Ono
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - T Miyoshi
- Okayama University, Department of Cardiovascular Medicine, Okayama, Japan
| | - Y Ohno
- Kawasaki University of Medical Welfare, Department of Medical Technology, Kurashiki, Japan
| | - Y Ueki
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - K Kuroda
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - K Kawamura
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - K Tokioka
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - T Ohe
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - Y Kawai
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
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Matsumoto S, Nakazawa G, Ohno Y, Ishihara M, Sakai K, Nakamura N, Murakami T, Natsumeda M, Kabuki T, Shibata A, Kida K, Konishi M, Ishii S, Ikeda T, Ikari Y. Efficacy of exogenous atrial natriuretic peptide in patients with heart failure with preserved ejection fraction: deficiency of atrial natriuretic peptide and replacement therapy. ESC Heart Fail 2020; 7:4172-4181. [PMID: 33037750 PMCID: PMC7754892 DOI: 10.1002/ehf2.13042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/21/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022] Open
Abstract
AIMS Exogenous atrial natriuretic peptide (ANP) may be a logical treatment for heart failure (HF) patients with ANP deficiency. Lower ANP concentrations may result from HF with preserved ejection fraction (HFpEF), which also results in lower brain natriuretic peptide levels in HFpEF relative to HF with reduced ejection fraction (HFrEF), although clinical features regarding circulating ANP in HFpEF and HFrEF have not been fully investigated during acute HF. Here, we characterized the differential regulation of circulating ANP and the efficacy of exogenous ANP (carperitide) in patients with acute HF, especially HFpEF. METHODS AND RESULTS Serum ANP levels before treatment and the diuretic effect of 0.0125 μg/kg/min of carperitide alone for the first 6 h were prospectively evaluated in 113 patients with acute HF who were divided into two groups: HFpEF vs. HFrEF. We mainly analysed the impact of baseline ANP levels and the presence of HFpEF on the diuretic effect of exogenous ANP. There was an inverse relationship between ANP levels and the diuretic effect of exogenous ANP (r2 = 0.19, P < 0.001). Patients with HFpEF had lower ANP levels (P < 0.001) and a greater diuretic effect of exogenous ANP than patients HFrEF (P < 0.001). HFpEF was an independent predictor of greater diuretic effect of exogenous ANP (P = 0.003), as with a lower baseline ANP level (P = 0.004). CONCLUSIONS Patients with HFpEF might have an aspect of ANP deficiency and represent a promising therapeutic target for modulating circulating ANP.
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Affiliation(s)
- Shingo Matsumoto
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan.,Department of Cardiovascular Medicine, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Gaku Nakazawa
- Department of Cardiology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan
| | - Mai Ishihara
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan
| | - Katsuaki Sakai
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan
| | - Norihito Nakamura
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan
| | - Tsutomu Murakami
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan
| | - Makoto Natsumeda
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan
| | - Takayuki Kabuki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Atsushi Shibata
- Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Keisuke Kida
- Department of Pharmacology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Masaaki Konishi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Shunsuke Ishii
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Kanagawa, Japan
| | - Takanori Ikeda
- Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Yuji Ikari
- Department of Cardiology, Tokai University Hospital, Kanagawa, Japan
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Nagai T, Horinouchi H, Ohno Y, Murakami T, Sakai K, Nakazawa G, Yoshioka K, Ikari Y. Predictors for non-delayed discharge after transcatheter aortic valve replacement: utility of echocardiographic parameters. Int J Cardiovasc Imaging 2020; 37:47-58. [PMID: 32712734 DOI: 10.1007/s10554-020-01944-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
Considering that transcatheter aortic valve replacement (TAVR) procedures have become less invasive, the duration for monitoring patient care after a successful TAVR can be reduced. Therefore, this study aimed to investigate the prognostic value of baseline echocardiographic parameters for non-delayed discharge in patients after TAVR. The study group included 154 consecutive patients (mean age: 84.4 ± 4.5 years; and 101 women) who underwent a TAVR. Comprehensive echocardiograms including both side indices of myocardial performance (IMP) and blood tests were obtained prior to the TAVR procedure. The median post-TAVR length of stay was 6 days while the mode and first quartile were both 4 days. Receiver operating characteristic curve analysis showed that the optimum cut-off value of the left-sided IMP in patients with a normal left ventricular ejection fraction (LVEF, ≥ 50%) (n = 124) for non-delayed discharge (≤ 4 days) was 0.34 with an area under the curve (AUC) value of 0.71563 and p value of < 0.0001, while the optimum cut-off value in patients with reduced LVEF (< 50%) (n = 30) was 0.47 with an AUC value of 0.77778 and p value of < 0.0120. An adjusted analysis indicated the negative left-sided IMP results as the only predictor for non-delayed discharge (p < 0.0001). Furthermore, the adjusted predictors for survival without early cardiovascular re-hospitalization within 6 months after TAVR were the positive left-sided IMP result, when the cut-off value of 0.52 was used, and the presence of elevated RAP of 8 to 15 mmHg. The early discharge policy should be carefully considered in high-risk populations, but the left-sided IMP may play a significant role in the pre-screening process.
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Affiliation(s)
- Tomoo Nagai
- Division of Cardiovascular Medicine, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1193, Japan.
| | - Hitomi Horinouchi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1193, Japan
| | - Yohei Ohno
- Division of Cardiovascular Medicine, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1193, Japan
| | - Tsutomu Murakami
- Division of Cardiovascular Medicine, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1193, Japan
| | - Katsuaki Sakai
- Division of Cardiovascular Medicine, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1193, Japan
| | - Gaku Nakazawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1193, Japan
| | - Koichiro Yoshioka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1193, Japan
| | - Yuji Ikari
- Division of Cardiovascular Medicine, Department of Internal Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1193, Japan
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Kamachi H, Homma S, Kawamura H, Yoshida T, Ohno Y, Ichikawa N, Yokota R, Funakoshi T, Maeda Y, Takahashi N, Amano T, Taketomi A. Intermittent pneumatic compression versus additional prophylaxis with enoxaparin for prevention of venous thromboembolism after laparoscopic surgery for gastric and colorectal malignancies: multicentre randomized clinical trial. BJS Open 2020; 4:804-810. [PMID: 32700415 PMCID: PMC7528532 DOI: 10.1002/bjs5.50323] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/09/2020] [Indexed: 11/06/2022] Open
Abstract
Background The role of antithrombotic chemoprophylaxis in prevention of venous thromboembolism (VTE) in laparoscopic surgery for gastric and colorectal malignancies is unknown. This study compared the addition of enoxaparin following intermittent pneumatic compression (IPC) with IPC alone in patients undergoing laparoscopic surgery for gastrointestinal malignancy. Methods In this multicentre RCT, eligible patients were older than 40 years and had a WHO performance status of 0 or 1. Exclusion criteria were prescription of antiplatelet or anticoagulant drugs and history of VTE. Patients were allocated to IPC or to ICP with enoxaparin in a 1 : 1 ratio. Stratification factors included sex, location of cancer, age 61 years and over, and institution. Enoxaparin was administered on days 1–7 after surgery. Primary outcome was VTE, evaluated by multidetector CT on day 7. Results Of 448 patients randomized, 208 in the IPC group and 182 in the IPC with enoxaparin group were evaluated. VTE occurred in ten patients (4·8 per cent) in the IPC group and six (3·3 per cent) in the IPC with enoxaparin group (P = 0·453). Proximal deep vein thrombosis and/or pulmonary embolism occurred in seven patients (3·4 per cent) in the IPC group and one patient (0·5 per cent) in the IPC with enoxaparin group (P = 0·050). All VTE events were asymptomatic and non‐fatal. Bleeding occurred in 11 of 202 patients in the IPC with enoxaparin group, and one patient needed a transfusion. All bleeding events were managed by discontinuation of the drug. Conclusion IPC with enoxaparin after laparoscopic surgery for gastric and colorectal malignancies did not reduce the rate of VTE. Registration number: UMIN000011667 (
https://www.umin.ac.jp/).
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Affiliation(s)
- H Kamachi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - S Homma
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - H Kawamura
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - T Yoshida
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Y Ohno
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - N Ichikawa
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - R Yokota
- Department of Surgery, Sunagawa City Medical Centre, Sunagawa, Japan
| | - T Funakoshi
- Department of Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Y Maeda
- Department of Gastrointestinal Surgery, National Hospital Organization Hokkaido Cancer Centre, Hokkaido
| | | | - T Amano
- Clinical Research and Medical Innovation Centre, Hokkaido University Hospital, Hokkaido, Japan
| | - A Taketomi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
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Affiliation(s)
- Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Katsuaki Sakai
- Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Gaku Nakazawa
- Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Yuji Ikari
- Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
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Cho H, Kishikawa T, Tokita Y, Suzuki M, Takemoto N, Hanamoto A, Fukusumi T, Yamamoto M, Fujii M, Ohno Y, Inohara H. Prevalence of human papillomavirus in oral gargles and tonsillar washings. Oral Oncol 2020; 105:104669. [PMID: 32259682 DOI: 10.1016/j.oraloncology.2020.104669] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/02/2020] [Accepted: 03/26/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Human papillomavirus (HPV) infection drives carcinogenesis in the oropharynx. No standard sampling or HPV detection methods for evaluating oropharyngeal HPV infection exist. The prevalence of oral HPV infection in Japan is unknown. MATERIALS AND METHODS We examined 435 healthy Japanese individuals to address whether adding tonsillar washing to oral gargling would improve HPV detection. We compared HPV assessment using GENOSEARCH HPV31 versus nested PCR and direct sequencing. Associations between HPV infection and demographic and behavioral characteristics were examined. RESULTS Most participants who were HPV-positive based on oral gargles were also HPV-positive based on tonsillar washings: 11 (64.7%) of 17 on nested PCR and 12 (70.6%) of 17 on GENOSEARCH HPV31. Although HPV infection was more prevalent in oral gargles followed by tonsillar washings than in oral gargles alone, the difference was not statistically significant (nested PCR, 4.8% vs. 3.9%, P = 0.46; GENOSEARCH HPV31, 5.3% vs. 3.9%, P = 0.33). The overall agreement between nested PCR and GENOSEARCH HPV31 was 98.6%, with 76.0% positive agreement. The overall prevalence of oral HPV infection in Japan was 5.7% (95% confidence interval, 3.9-8.3%). Men had a significantly higher prevalence of oral HPV infection than women (8.3% vs. 2.6%, P = 0.02). Infection increased with number of lifetime sexual partners (P < 0.001 for trend). CONCLUSION The oropharynx is probably the major source of HPV-infected cells in oral gargles. Oral gargling could be a standard sampling method for evaluating oropharyngeal HPV infection. GENOSEARCH HPV31 could be an option for oral HPV detection.
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Affiliation(s)
- H Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - T Kishikawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Y Tokita
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan; Department of Nursing, Kyoto Tachibana University, Kyoto, Japan.
| | - M Suzuki
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - N Takemoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - A Hanamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - T Fukusumi
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - M Yamamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
| | - M Fujii
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Y Ohno
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Suita, Japan.
| | - H Inohara
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
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Nagai T, Sakama S, Hasegawa M, Ohno Y, Ikari Y. Augmented left ventricular dyssynchrony by low-dose dobutamine stress suggested excellent cardiac resynchronization responses in low-flow low-gradient aortic stenosis. Eur Heart J Cardiovasc Imaging 2020; 21:933. [DOI: 10.1093/ehjci/jeaa042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/07/2020] [Accepted: 02/26/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tomoo Nagai
- Division of Cardiovascular Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa 259-1193, Japan
| | - Susumu Sakama
- Division of Cardiovascular Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa 259-1193, Japan
| | - Misaki Hasegawa
- Division of Cardiovascular Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa 259-1193, Japan
| | - Yohei Ohno
- Division of Cardiovascular Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa 259-1193, Japan
| | - Yuji Ikari
- Division of Cardiovascular Medicine, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa 259-1193, Japan
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