المؤلفون: Maeda, Makiko, Humber, Douglas, Hida, Eisuke, Ohtani, Tomohito, Wang, Guannan, Wu, Tong, Takeda, Shiori, Situ, Jacinta, Hayashi, Jun, Nonen, Shinpei, Takeda, Toshihiro, Okamoto, Hiroshi, Hori, Masatsugu, Sakata, Yasushi, Fujio, Yasushi, Tsunoda, Shirley

المصدر: PLoS ONE. 19(3)

مصطلحات موضوعية: Humans, Adrenergic beta-Antagonists, Carvedilol, Heart Failure, Japan, Stroke Volume, Treatment Outcome, Ventricular Dysfunction, Left

الوصف: The Japanese national guidelines recommend significantly lower doses of carvedilol for heart failure with reduced ejection fraction (HFrEF) management than the US guidelines. Using real-world data, we determined whether initial and target doses of carvedilol in Japanese patients (JPNs) differ from those in US patients (USPs), especially in Asian Americans (ASA) and Caucasians (CA), and investigated differences in outcomes. We collected data from the electronic medical records, including demographics, carvedilol dosing, tolerability, cardiac functional indicators like EF, cardiovascular events including all-cause deaths, and laboratory values from the University of California, San Diego Health and Osaka University. JPNs had significantly lower doses (mg/day) of carvedilol initiation (66 USPs composed of 38 CAs and 28 ASAs, 17.1±16.2; 93 JPNs, 4.3±4.2, p

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/796334fsTest

المؤلفون: Sotomi, Yohei, Tamaki, Shunsuke, Hikoso, Shungo, Nakatani, Daisaku, Okada, Katsuki, Dohi, Tomoharu, Sunaga, Akihiro, Kida, Hirota, Sato, Taiki, Matsuoka, Yuki, Sakamoto, Daisuke, Kitamura, Tetsuhisa, Komukai, Sho, Seo, Masahiro, Yano, Masamichi, Hayashi, Takaharu, Nakagawa, Akito, Nakagawa, Yusuke, Ohtani, Tomohito, Yasumura, Yoshio, Yamada, Takahisa, Sakata, Yasushi, on behalf of the OCVC-Heart Failure Investigators, Watanabe, Tetsuya, Higuchi, Yoshiharu, Masuda, Masaharu, Asai, Mitsutoshi, Mano, Toshiaki, Fuji, Hisakazu, Masuda, Daisaku, Shutta, Ryu, Yamashita, Shizuya, Sairyo, Masami, Abe, Haruhiko, Ueda, Yasunori, Matsumura, Yasushi, Nagai, Kunihiko, Nishino, Masami, Tanouchi, Jun, Arita, Yoh, Ogasawara, Nobuyuki, Ishizu, Takamaru, Ichikawa, Minoru, Takano, Yuzuru, Rin, Eisai, Shinoda, Yukinori, Tachibana, Koichi, Hoshida, Shiro, Izumi, Masahiro, Yamamoto, Hiroyoshi, Kato, Hiroyasu, Nakatani, Kazuhiro, Yasuga, Yuji, Nishio, Mayu, Hirooka, Keiji, Yoshimura, Takahiro, Kashiwase, Kazunori, Hasegawa, Shinji, Tani, Akihiro, Okumoto, Yasushi, Makino, Yasunaka, Onishi, Toshinari, Iwakura, Katsuomi, Kijima, Yoshiyuki, Kitao, Takashi, Fujita, Masashi, Harada, Koichiro, Kumada, Masahiro, Nakagawa, Osamu, Araki, Ryo, Yamada, Takayuki, Oeun, Bolrathanak, Akazawa, Yasuhiro, Nakamoto, Kei, Sera, Fusako, Kioka, Hidetaka, Takeda, Toshihiro, Mizuno, Hiroya

مصطلحات موضوعية: Heart failure and cardiomyopathies

الوصف: Objective The heterogeneous pathophysiology of the diverse heart failure with preserved ejection fraction (HFpEF) phenotypes needs to be examined. We aim to assess differences in the biomarkers among the phenotypes of HFpEF and investigate its multifactorial pathophysiology. Methods This study is a retrospective analysis of the PURSUIT-HFpEF Study (N=1231), an ongoing, prospective, multicentre observational study of acute decompensated HFpEF. In this registry, there is a predefined subcohort in which we perform multibiomarker tests (N=212). We applied the previously established machine learning-based clustering model to the subcohort with biomarker measurements to classify them into four phenotypes: phenotype 1 (n=69), phenotype 2 (n=49), phenotype 3 (n=41) and phenotype 4 (n=53). Biomarker characteristics in each phenotype were evaluated. Results Phenotype 1 presented the lowest value of N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive C reactive protein, tumour necrosis factor-α, growth differentiation factor (GDF)-15, troponin T and cystatin C, whereas phenotype 2, which is characterised by hypertension and cardiac hypertrophy, showed the highest value of these markers. Phenotype 3 showed the second highest value of GDF-15 and cystatin C. Phenotype 4 presented a low NT-proBNP value and a relatively high GDF-15. Conclusions Distinctive characteristics of biomarkers in HFpEF phenotypes would indicate differential underlying mechanisms to be elucidated. The contribution of inflammation to the pathogenesis varied considerably among different HFpEF phenotypes. Systemic inflammation substantially contributes to the pathophysiology of the classic HFpEF phenotype with cardiac hypertrophy. Trial registration number UMIN-CTR ID: UMIN000021831.

وصف الملف: text/html

العلاقة: http://heart.bmj.com/cgi/content/short/110/6/441Test; http://dx.doi.org/10.1136/heartjnl-2023-323059Test

الإتاحة: https://doi.org/10.1136/heartjnl-2023-323059Test
http://heart.bmj.com/cgi/content/short/110/6/441Test

المؤلفون: Tamaki, Shunsuke, Sotomi, Yohei, Nagai, Yoshiyuki, Shutta, Ryu, Masuda, Daisaku, Makino, Nobuhiko, Yamashita, Shizuya, Seo, Masahiro, Yamada, Takahisa, Nakagawa, Akito, Yasumura, Yoshio, Nakagawa, Yusuke, Yano, Masamichi, Hayashi, Takaharu, Hikoso, Shungo, Nakatani, Daisaku, Ohtani, Tomohito, Sakata, Yasushi

المصدر: ESC Heart Failure ; ISSN 2055-5822 2055-5822

الوصف: Aims Interleukin‐16 (IL‐16) has been reported to mediate left ventricular myocardial fibrosis and stiffening in patients with heart failure with preserved ejection fraction (HFpEF). We sought to elucidate whether IL‐16 has a distinct impact on pathophysiology and prognosis across different subphenotypes of acute HFpEF. Methods and results We analysed 211 patients enrolled in a prospective multicentre registry of acute decompensated HFpEF for whom serum IL‐16 levels after stabilization were available (53% female, median age 81 [interquartile range 75–85] years). We divided this sub‐cohort into four phenogroups using our established clustering algorithm. The study endpoint was all‐cause death. Patients were subclassified into phenogroup 1 (‘rhythm trouble’ [ n = 69]), phenogroup 2 (‘ventricular‐arterial uncoupling’ [ n = 49]), phenogroup 3 (‘low output and systemic congestion’ [ n = 41]), and phenogroup 4 (‘systemic failure’ [ n = 52]). After a median follow‐up of 640 days, 38 patients had died. Among the four phenogroups, phenogroup 2 had the highest IL‐16 level. The IL‐16 level showed significant associations with indices of cardiac hypertrophy, diastolic dysfunction, and congestion only in phenogroup 2. Furthermore, the IL‐16 level had a significant predictive value for all‐cause death only in phenogroup 2 (C‐statistic 0.750, 95% confidence interval 0.606–0.863, P = 0.017), while there was no association between the IL‐16 level and the endpoint in the other phenogroups. Conclusions Our results indicated that the serum IL‐16 level had a significant association with indices that reflect the pathophysiology and prognosis of HFpEF in a specific phenogroup in acute HFpEF.

الإتاحة: https://doi.org/10.1002/ehf2.14808Test

المؤلفون: Shiraki, Tatsuya, Mizuno, Hiroya, Kishi, Takuya, Asakura, Masanori, Asanoi, Hidetsugu, Yasumura, Yoshio, Sakata, Yasushi

المصدر: ESC Heart Failure ; ISSN 2055-5822 2055-5822

الوصف: This case report describes the application of ultrasound renal denervation (uRDN) using the Paradise System in a patient with heart failure with preserved ejection fraction. Initially, the cardiac sympathetic nerve activity of the patient exhibited a late heart/mediastinum (H/M) ratio of 2.00 and a washout rate of 66.0% by cardiac iodine‐123 metaiodobenzylguanidine ( 123 I‐MIBG) scintigraphy. Subsequently, the patient underwent transfemoral uRDN targeting the left, right upper, and right lower renal arteries. At the 6 month follow‐up, no significant change was observed in 123 I‐MIBG findings; however, the estimated stressed blood volume (eSBV) decreased from 1722 to 1029 mL/70 kg. At 18 months, 123 I‐MIBG findings improved, with the late H/M ratio reaching 2.76 and the washout rate decreasing to 43.1%. This case report highlights the potential of uRDN in reducing eSBV within 6 months and subsequently improving cardiac sympathetic nerve activity at the 18 month follow‐up.

الإتاحة: https://doi.org/10.1002/ehf2.14770Test

المؤلفون: Sekihara, Takayuki, Oka, Takafumi, Ozu, Kentaro, Sakata, Yasushi

المصدر: Journal of Cardiovascular Electrophysiology ; volume 35, issue 4, page 862-866 ; ISSN 1045-3873 1540-8167

الوصف: Introduction Persistent left superior vena cava (PLSVC) is one of the major sources of triggers and drivers of atrial fibrillation (AF). There has been no established PLSVC ablation procedure to eliminate the arrhythmogenicity along the entire length of PLSVC. Methods and Results A 70‐year‐old woman with a history of two previous catheter ablations for AF, mitral valvuloplasty, and an unroofed coronary sinus‐type atrial septal defect closure underwent the redo AF ablations. The AF trigger and driver were identified within the patient's enlarged PLSVC. The AF was treated by complete PLSVC free wall isolation. Conclusion Complete PLSVC free wall isolation may be an effective ablation method to eliminate the arrhythmogenicity along the entire length of the PLSVC.

الإتاحة: https://doi.org/10.1111/jce.16207Test

المؤلفون: Yano, Masamichi, Nishino, Masami, Kawanami, Shodai, Ukita, Kohei, Kawamura, Akito, Yasumoto, Koji, Tsuda, Masaki, Okamoto, Naotaka, Matsunaga‐Lee, Yasuharu, Egami, Yasuyuki, Yamada, Takahisa, Yasumura, Yoshio, Seo, Masahiro, Hayashi, Takaharu, Nakagawa, Akito, Nakagawa, Yusuke, Tamaki, Shunsuke, Sotomi, Yohei, Nakatani, Daisaku, Hikoso, Shungo, Sakata, Yasushi

المصدر: ESC Heart Failure ; ISSN 2055-5822 2055-5822

الوصف: Aims Low‐density lipoprotein cholesterol (LDL‐C), anaemia and low platelets have been associated with worse clinical outcomes in heart failure patients. We investigated the relationship between the combination of these three components and clinical outcome in patients with heart failure with preserved ejection fraction (HFpEF). Methods and results We examined the data of 1021 patients with HFpEF hospitalized with acute decompensated heart failure (HF) from the PURSUIT‐HFpEF registry, a prospective, multicenter observational study. The enrolled patients were classified into four groups by an LEP ( L DL‐C, E rythrocyte, and P latelet) score of 0 to 3 points, with 1 point each for LDL‐C, erythrocyte and platelet values less than the cut‐off values as calculated by receiver operating characteristic curve analysis. The endpoint, a composite of all‐cause death and HF readmission, was evaluated among the four groups. Median follow‐up duration was 579 [300, 978] days. Risk of the composite endpoint significantly differed among the four groups ( P < 0.001). Kaplan–Meier analysis showed that the groups with an LEP score of 2 had higher risk of the composite endpoint than those with an LEP score of 0 or 1 ( P < 0.001, and P = 0.013, respectively), while those with an LEP score of 3 had higher risk than those with an LEP score of 0, 1 or 2 ( P < 0.001, P < 0.001 and P = 0.020, respectively). Cox proportional hazards analysis showed that an LEP score of 3 was significantly associated with the composite endpoint ( P = 0.030). Kaplan–Meier analysis showed that risk of the composite of all‐cause death and HF readmission was significantly higher in low LDL values (less than the cut‐off values as calculated by receiver operating characteristic curve analysis) patients with statin use than in those without statin use (log rank P = 0.002). Conclusions LEP score, which comprehensively reflects extra‐cardiac co‐morbidities, is significantly associated with clinical outcomes in HFpEF patients.

الإتاحة: https://doi.org/10.1002/ehf2.14734Test

المؤلفون: Hasegawa, Moyu, Miki, Kenji, Kawamura, Takuji, Takei Sasozaki, Ikue, Higashiyama, Yuki, Tsuchida, Masaru, Kashino, Kunio, Taira, Masaki, Ito, Emiko, Takeda, Maki, Ishida, Hidekazu, Higo, Shuichiro, Sakata, Yasushi, Miyagawa, Shigeru

المساهمون: Japan Society for the Promotion of Science, Japan Agency for Medical Research and Development

المصدر: Development, Growth & Differentiation ; volume 66, issue 2, page 119-132 ; ISSN 0012-1592 1440-169X

الوصف: Research on cardiomyopathy models using engineered heart tissue (EHT) created from disease‐specific induced pluripotent stem cells (iPSCs) is advancing rapidly. However, the study of restrictive cardiomyopathy (RCM), a rare and intractable cardiomyopathy, remains at the experimental stage because there is currently no established method to replicate the hallmark phenotype of RCM, particularly diastolic dysfunction, in vitro. In this study, we generated iPSCs from a patient with early childhood‐onset RCM harboring the TNNI3 R170W mutation (R170W‐iPSCs). The properties of R170W‐iPSC‐derived cardiomyocytes (CMs) and EHTs were evaluated and compared with an isogenic iPSC line in which the mutation was corrected. Our results indicated altered calcium kinetics in R170W‐iPSC‐CMs, including prolonged tau, and an increased ratio of relaxation force to contractile force in R170W‐EHTs. These properties were reversed in the isogenic line, suggesting that our model recapitulates impaired relaxation of RCM, i.e., diastolic dysfunction in clinical practice. Furthermore, overexpression of wild‐type TNNI3 in R170W‐iPSC‐CMs and ‐EHTs effectively rescued impaired relaxation. These results highlight the potential efficacy of EHT, a modality that can accurately recapitulate diastolic dysfunction in vitro, to elucidate the pathophysiology of RCM, as well as the possible benefits of gene therapies for patients with RCM.

الإتاحة: https://doi.org/10.1111/dgd.12909Test

المؤلفون: Sato, Taiki, Sotomi, Yohei, Hikoso, Shungo, Kitamura, Tetsuhisa, Nakatani, Daisaku, Okada, Katsuki, Dohi, Tomoharu, Sunaga, Akihiro, Kida, Hirota, Matsuoka, Yuki, Tanaka, Nobuaki, Watanabe, Tetsuya, Makino, Nobuhiko, Egami, Yasuyuki, Oka, Takafumi, Minamiguchi, Hitoshi, Miyoshi, Miwa, Okada, Masato, Kanda, Takashi, Matsuda, Yasuhiro, Kawasaki, Masato, Masuda, Masaharu, Inoue, Koichi, Sakata, Yasushi, Mano, Toshiaki, Fukunami, Masatake, Yamada, Takahisa, Furukawa, Yoshio, Hasegawa, Shinji, Higuchi, Yoshiharu, Hirata, Akio, Tanouchi, Jun, Nishino, Masami, Matsunaga, Yasuharu, Matsumura, Yasushi, Mizuno, Hiroya, Takeda, Toshihiro, Nakano, Tomoaki, Ozu, Kentaro, Suna, Shinichiro, Oeun, Bolrathanak, Tanaka, Koji, Minamisaka, Tomoko, Hoshida, Shiro

المصدر: Scientific Reports ; volume 14, issue 1 ; ISSN 2045-2322

مصطلحات موضوعية: Multidisciplinary

الوصف: Identifying patients who would benefit from extensive catheter ablation along with pulmonary vein isolation (PVI) among those with persistent atrial fibrillation (AF) has been a subject of controversy. The objective of this study was to apply uplift modeling, a machine learning method for analyzing individual causal effect, to identify such patients in the EARNEST-PVI trial, a randomized trial in patients with persistent AF. We developed 16 uplift models using different machine learning algorithms, and determined that the best performing model was adaptive boosting using Qini coefficients. The optimal uplift score threshold was 0.0124. Among patients with an uplift score ≥ 0.0124, those who underwent extensive catheter ablation (PVI-plus) showed a significantly lower recurrence rate of AF compared to those who received only PVI (PVI-alone) (HR 0.40; 95% CI 0.19–0.84; P -value = 0.015). In contrast, among patients with an uplift score < 0.0124, recurrence of AF did not significantly differ between PVI-plus and PVI-alone (HR 1.17; 95% CI 0.57–2.39; P -value = 0.661). By employing uplift modeling, we could effectively identify a subset of patients with persistent AF who would benefit from PVI-plus. This model could be valuable in stratifying patients with persistent AF who need extensive catheter ablation before the procedure.

الإتاحة: https://doi.org/10.1038/s41598-024-52976-7Test
https://www.nature.com/articles/s41598-024-52976-7.pdfTest
https://www.nature.com/articles/s41598-024-52976-7Test

المؤلفون: Iwakura, Katsuomi, Onishi, Toshinari, Okamura, Atsunori, Koyama, Yasushi, Tanaka, Nobuaki, Okada, Masato, Fujii, Kenshi, Seo, Masahiro, Yamada, Takahisa, Yano, Masamichi, Hayashi, Takaharu, Yasumura, Yoshio, Nakagawa, Yusuke, Tamaki, Shunsuke, Nakagawa, Akito, Sotomi, Yohei, Hikoso, Shungo, Nakatani, Daisaku, Sakata, Yasushi, Watanabe, Tetsuya, Higuchi, Yoshiharu, Masuda, Masaharu, Asai, Mitsutoshi, Mano, Toshiaki, Fuji, Hisakazu, Masuda, Daisaku, Shutta, Ryu, Yamashita, Shizuya, Sairyo, Masami, Abe, Haruhiko, Ueda, Yasunori, Matsumura, Yasushi, Nagai, Kunihiko, Nishino, Masami, Tanouchi, Jun, Arita, Yoh, Ogasawara, Nobuyuki, Ishizu, Takamaru, Ichikawa, Minoru, Takano, Yuzuru, Rin, Eisai, Shinoda, Yukinori, Tachibana, Koichi, Hoshida, Shiro, Izumi, Masahiro, Yamamoto, Hiroyoshi, Kato, Hiroyasu, Nakatani, Kazuhiro, Yasuga, Yuji, Nishio, Mayu

المساهمون: Roche Diagnostics, FUJIFILM Toyama Chemical

المصدر: Scientific Reports ; volume 14, issue 1 ; ISSN 2045-2322

مصطلحات موضوعية: Multidisciplinary

الوصف: The coexistence of heart failure is frequent and associated with higher mortality in patients with type 2 diabetes (T2DM), and its management is a critical issue. The WATCH-DM risk score is a tool to predict heart failure in patients with type 2 diabetes mellitus (T2DM). We investigated whether it could estimate outcomes in T2DM patients with heart failure with preserved ejection fraction (HFpEF). The WATCH-DM risk score was calculated in 418 patients with T2DM hospitalized for HFpEF (male 49.5%, age 80 ± 9 years, HbA1c 6.8 ± 1.0%), and they were divided into the “average or lower” (≤ 10 points), “high” (11–13 points) and “very high” (≥ 14 points) risk groups. We followed patients to observe all-cause death for 386 days (median). We compared the area under the curve (AUC) of the WATCH-DM score for predicting 1-year mortality with that of the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score and of the Barcelona Bio-Heart Failure Risk (BCN Bio-HF). Among the study patients, 108 patients (25.8%) had average or lower risk scores, 147 patients (35.2%) had high risk scores, and 163 patients (39.0%) had very high risk scores. The Cox proportional hazard model selected the WATCH-DM score as an independent predictor of all-cause death (HR per unit 1.10, 95% CI 1.03 to 1.19), and the “average or lower” risk group had lower mortality than the other groups (p = 0.047 by log-rank test). The AUC of the WATCH-DM for 1-year mortality was 0.64 (95% CI 0.45 to 0.74), which was not different from that of the MAGGIC score (0.72, 95% CI 0.63 to 0.80, p = 0.08) or that of BCN Bio-HF (0.70, 0.61 to 0.80, p = 0.25). The WATCH-DM risk score can estimate prognosis in T2DM patients with HFpEF and can identify patients at higher risk of mortality.

الإتاحة: https://doi.org/10.1038/s41598-024-52101-8Test
https://www.nature.com/articles/s41598-024-52101-8.pdfTest
https://www.nature.com/articles/s41598-024-52101-8Test

المؤلفون: Okada, Masato, Inoue, Koichi, Tanaka, Nobuaki, Tanaka, Koji, Hirao, Yuko, Iwakura, Katsuomi, Egami, Yasuyuki, Masuda, Masaharu, Watanabe, Tetsuya, Minamiguchi, Hitoshi, Oka, Takafumi, Hikoso, Shungo, Sunaga, Akihiro, Okada, Katsuki, Nakatani, Daisaku, Sotomi, Yohei, Sakata, Yasushi, Mano, Toshiaki, Matsumura, Yasushi, Kawasaki, Masato, Yamada, Takahisa, Miyoshi, Miwa, Kanda, Takashi, Makino, Nobuhiko, Higuchi, Yoshiharu, Matsunaga, Yasuharu, Nishino, Masami, Tanouchi, Jun, Sato, Taiki, Kida, Hirota, Nakano, Tomoaki, Ozu, Kentaro, Dohi, Tomoharu, Takeda, Toshihiro, Minamisaka, Tomoko

المصدر: Europace ; ISSN 1099-5129 1532-2092

الوصف: Aims Blood stasis is crucial in developing left atrial (LA) thrombi. LA appendage peak flow velocity (LAAFV) is a quantitative parameter for estimating thromboembolic risk. However, its impact on LA thrombus resolution and clinical outcomes remains unclear. Methods and Results The LAT study was a multicenter observational study investigating patients with atrial fibrillation (AF) and silent LA thrombi detected by transesophageal echocardiography (TEE). Among 17,436 TEE procedures for patients with AF, 297 patients (1.7%) had silent LA thrombi. Excluding patients without follow-up examinations, we enrolled 169 whose baseline LAAFV was available. Oral anticoagulation use increased from 85.7% at baseline to 97.0% at the final follow-up (p < 0.001). During 1-year, LA thrombus resolution was confirmed in 130 (76.9%) patients within 76 (34–138) days. Conversely, 26 had residual LA thrombi, 8 had thromboembolisms, and 5 required surgical removal. These patients with failed thrombus resolution had lower baseline LAAFV than those with successful resolution (18.0 [15.8–22.0] vs. 22.2 [17.0–35.0], p = 0.003). Despite limited predictive power (area under the curve, 0.659; p = 0.001), LAAFV ≤20.0 cm/s (best cutoff) significantly predicted failed LA thrombus resolution, even after adjusting for potential confounders (odds ratio, 2.72; 95% confidence interval, 1.22–6.09; p = 0.015). The incidence of adverse outcomes including ischemic stroke/systemic embolism, major bleeding, or all-cause death was significantly higher in patients with reduced LAAFV than in those with preserved LAAFV (28.4% vs. 11.6%, log-rank p = 0.005). Conclusions Failed LA thrombus resolution was not rare in patients with AF and silent LA thrombi. Reduced LAAFV was associated with failed LA thrombus resolution and adverse clinical outcomes.

الإتاحة: https://doi.org/10.1093/europace/euae120Test