International heart journal最新文献

{"title":"Impact of Multidisciplinary Interventions on the Enhancement of Guideline-Directed Medical Therapy and Clinical Education in Hospitalized Heart Failure Patients.","authors":"Hiroshi Onoda, Teruhiko Imamura, Ryuichi Ushijima, Koichiro Kinugawa","doi":"10.1536/ihj.25-490","DOIUrl":"10.1536/ihj.25-490","url":null,"abstract":"<p><p>Although the efficacy of quadruple therapy-including angiotensin receptor neprilysin inhibitor-in patients with heart failure is well established, the impact of multidisciplinary interventions on its implementation in real-world clinical practice remains unclear.We retrospectively included 90 patients who received multidisciplinary intervention between April 2023 and March 2024 and 94 patients who received conventional care between April 2020 and March 2021. In the multidisciplinary care group, a standardized heart failure checklist was used to confirm the optimization of heart failure treatment. The rates of nutritional counseling, medication education, and rehabilitation introduction, as well as the implementation rate of quadruple therapy during hospitalization for heart failure, were compared between the groups.The mean age of patients was 75.7 years; 58.6% were male, and 45.3% had their first heart failure hospitalization. Background characteristics were not significantly different between the groups. The implementation rates for nutritional instruction, medication instruction, and rehabilitation were 51.2%, 72.0%, and 88.9% in the multidisciplinary intervention group, which were significantly higher than those in the conventional care group (26.3%, 49.5%, and 54.3%, respectively) (all P < 0.001). The rate of quadruple therapy implementation was higher (74.4%) compared to the conventional care group (30.6%) among the individuals with reduced ejection fraction (P < 0.001).In carefully-selected hospitalized patients with heart failure, multidisciplinary intervention was associated with increased utilization of evidence-based therapies, including quadruple therapy, highlighting its potential to enhance the quality of care in real-world clinical settings.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":" ","pages":"53-60"},"PeriodicalIF":1.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of a Nomogram Model Constructed on the Basis of Residual Cholesterol in Predicting Major Post-Interventional Adverse Cardiovascular Events in Patients with Acute Myocardial Infarction.","authors":"Xiaoyan Yin, Yuanzhuo Zhang, Lei Ren","doi":"10.1536/ihj.24-618","DOIUrl":"10.1536/ihj.24-618","url":null,"abstract":"<p><p>The aim of this study was to construct a residual cholesterol (RC)-based nomogram prediction model and assess its value in predicting the risk of major adverse cardiovascular events (MACE) after emergency percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).Retrospective analysis of patients from Fuyang People's Hospital who underwent emergency PCI for AMI at our hospital between January 2022 and December 2023 was performed, and univariate logistic regression was used to screen the risk factors for the first occurrence of MACE in the patients, while multivariable logistic regression analysis was used to construct a prediction model. Internal validation was performed using 1,000 bootstrap resampling. The predictive effect of the nomogram model was evaluated using the receiver operating characteristic curve (ROC), Hosmer-Lemeshow deviance test, and decision curve analysis (DCA).Logistic regression analysis showed that residual cholesterol, greater than 90 minutes from symptom onset to first medical contact (SO-to-FMC > 90 minutes), number of involved coronary vessels, Killip scale II-IV, and hemoglobin concentration were factors influencing the occurrence of MACE after PCI in these AMI patients (P < 0.05). The area under the curve (ROC-AUC) of the nomogram model for predicting the risk of developing postoperative MACE was 0.780 (0.721-0.839); the result of the Hosmer-Lemeshow test of deviance, χ² = 4.758 (P = 0.783), suggests that the model shows a moderately discriminatory and calibrated decision analysis curve; DCA shows a net clinical benefit with the nomogram model.RC is a promising biomarker for identifying AMI patients at high risk of postoperative MACE, and multivariate models based on RC can be used as quick and easy tools to identify these patients.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":" ","pages":"1-10"},"PeriodicalIF":1.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial Injury and Incidence of Early Recurrence of Atrial Fibrillation after Catheter Ablation between Two Types of Cryoballoon Systems.","authors":"Satoko Shiomi, Michifumi Tokuda, Ui Takato, Ryutaro Sakurai, Yoshito Yamazaki, Takuya Matsumoto, Hidenori Sato, Hirotsuna Oseto, Masaaki Yokoyama, Kenichi Tokutake, Seigo Yamashita, Teiichi Yamane","doi":"10.1536/ihj.25-374","DOIUrl":"10.1536/ihj.25-374","url":null,"abstract":"<p><p>Two types of cryoballoon (CB) systems are currently available for catheter ablation of atrial fibrillation (AF). It is not clear how the difference between POLARx (Boston Scientific) and AFA-Pro (Medtronic) relates to myocardial injury and the incidence of early recurrence of fibrillation (ERAF).Patients (n = 137) who underwent catheter ablation for paroxysmal AF by 2 CB devices were included (AFA-Pro in 87; POLARx in 50). We assessed creatine kinase (CK)-MB pre and post-procedure, ERAF, and the number of atrial premature contractions (APCs) at Holter monitoring 1 month and 3 months after the procedure. The change ratio was defined by the following formula: (post-procedure/pre-procedure). ERAF is defined as the recurrence of AF within 90 days after the procedure.The 2 groups did not differ significantly in the number of CB applications or the percentage of touch-up applications by radiofrequency catheter. The CK-MB change ratio was considerably higher in the POLARx group than the AFA-Pro group (19.3 ± 21.6 versus 27.4 ± 21.3; P = 0.036). The incidence of ERAF was similar between the 2 groups (15% versus 24%; P = 0.23). Additionally, there were no significant differences in the number of APCs (120 [39-784] versus 147 [43-1039]; P = 0.70) or AF recurrence (3% versus 12%; P = 0.10).POLARx causes stronger myocardial injury than AFA-Pro but does not increase ERAF and APC numbers.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":" ","pages":"20-26"},"PeriodicalIF":1.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Resolution of Aortic Root Thrombosis After Left Ventricular Assist Device Implantation.","authors":"Takumi Hatta, Keisuke Kojima, Riku Arai, Yasuo Okumura","doi":"10.1536/ihj.25-521","DOIUrl":"10.1536/ihj.25-521","url":null,"abstract":"","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":" ","pages":"103-104"},"PeriodicalIF":1.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Preoperative Diuretics Treatment on Long-Term Clinical Outcomes After Transcatheter Aortic Valve Implantation.","authors":"Shun Hirosawa, Hiroaki Yokoyama, Ken Yamazaki, Shun Shikanai, Michiko Tsushima, Noritomo Narita, Maiko Senoo, Hiroaki Ichikawa, Shuji Shibutani, Kenji Hanada, Yoshiaki Saito, Kenyu Murata, Yuki Imamura, Ryosuke Higuchi, Kenichi Hagiya, Itaru Takamisawa, Mamoru Nanasato, Nobuo Iguchi, Morimasa Takayama, Jun Shimizu, Harutoshi Tamura, Shinichiro Doi, Shinya Okazaki, Masaki Ishiyama, Motoki Fukutomi, Shuichiro Takanashi, Mike Saji, Masahito Minakawa, Hirofumi Tomita","doi":"10.1536/ihj.25-359","DOIUrl":"https://doi.org/10.1536/ihj.25-359","url":null,"abstract":"<p><p>Diuretics are used to relieve congestive symptoms in patients with severe aortic stenosis (AS). However, the effect of preprocedural diuretic treatment on long-term outcomes in AS patients who undergoing transcatheter aortic valve implantation (TAVI) remains unclear. We prospectively enrolled 4,903 consecutive AS patients who underwent TAVI in 7 Japanese hospitals between April 2010 and June 2024 and evaluated the effect of preprocedural diuretics treatment on clinical outcomes. Patients were divided into 2 groups as follows: the Diuretics group, who received diuretic treatment before TAVI (n = 2,073), and the Non-Diuretics group without diuretic treatment (n = 2,830). The median observation period was 2.1 years. The Diuretics group was older and had higher surgical risk scores and more comorbidities, including prior myocardial infarction, atrial fibrillation/flutter, and peripheral artery disease. The Diuretics group included more patients with New York Heart Association (NYHA) classification III/IV, lower left ventricular ejection fraction, and reduced renal function. They had significantly worse all-cause and cardiovascular mortality than those in the Non-Diuretics group (38% versus 26% and 18% versus 10%, respectively; P < 0.001 by log-rank test). After propensity score matching to minimize the influence of confounding factors, preoperative diuretic treatment was associated with worse all-cause mortality (hazard ratio [HR]: 1.29, 95% confidence interval [CI]: 1.06-1.58, P = 0.012) and cardiovascular mortality (HR: 1.61, 95%CI: 1.15-2.26, P = 0.006). Two fifths of AS patients who undergoing TAVI received preoperative diuretics, and those patients had worse all-cause and cardiovascular mortality. Preprocedural diuretic treatment was an independent predictor of all-cause and cardiovascular mortality after TAVI.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 1","pages":"27-34"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness Analysis of Implementing the Nagasaki Acute Myocardial Infarction Secondary Prevention Clinical Pathway.","authors":"Masaya Kurobe, Ataru Igarashi, Yosuke Yamanaka, Akihito Uda, Katsuya Mori, Sachie Inoue, Mizuki Yoshimura, Satoshi Ikeda, Koji Maemura","doi":"10.1536/ihj.25-323","DOIUrl":"https://doi.org/10.1536/ihj.25-323","url":null,"abstract":"<p><p>Due to the poor prognosis associated with acute coronary syndromes (ACSs), intensive low-density lipoprotein cholesterol (LDL-C) management therapy is recommended as early as possible after the onset of ACS, with the goal of lowering plasma LDL-C to < 70 mg/dL. The purpose of this study was to evaluate the cost-effectiveness of implementing the Nagasaki Acute Myocardial Infarction Secondary Prevention Clinical Pathway (NASP) using medical records (n = 385, pre-implementation group:224, post-implementation group:161) extracted from 8 hospitals in Nagasaki.Cost-effectiveness of implementing NASP was evaluated by a lifetime simulation using mathematical models. Drug costs for lipid-lowering therapy were calculated from actual prescriptions and treatment costs for each cardiovascular disease (CVD) event and utility scores were based on the literature. The risk of each CVD event was estimated by the equation consisting of the following variables: LDL-C, baseline CVD risks estimated using real-world clinical practice data, rate ratio per unit change in LDL-C and age. Implementation of NASP was evaluated as dominant, with an incremental gain of 0.058 quality-adjusted life years (QALYs) and expected cost savings of JPY 59,507 per person.Implementing NASP can be expected to reduce costs, in addition to increasing QALYs by preventing CVD. Further clinical and economic evaluation of long-term follow-up with a collaborative pathway to the general physician after discharge from the hospital is expected.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 2","pages":"114-122"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best Reviewers for 2025.","authors":"","doi":"10.1536/ihj.67.105","DOIUrl":"https://doi.org/10.1536/ihj.67.105","url":null,"abstract":"","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 1","pages":"105"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between Hematocrit and All-Cause Mortality in Patients with Acute Congestive Heart Failure.","authors":"Xiaotian Ren, Ye Zhu, Wenyuan Wang, Xiaoli Bian","doi":"10.1536/ihj.25-187","DOIUrl":"https://doi.org/10.1536/ihj.25-187","url":null,"abstract":"<p><p>Hematocrit (HCT) has clinical significance in the prognosis of acute heart failure (AHF). This study investigated the association between HCT and 365-day all-cause mortality rate from the MIMIC-IV database. We also explored the specific inflection point for HCT that affects the varying clinical prognoses in patients with AHF.A total of 2,193 patients with AHF were extracted from the MIMIC-IV database. Patients were divided into 3 groups based on HCT levels at admission: low-HCT (< 30%), middle-HCT (30% - 40%), and high-HCT groups (≥ 40%). Ten variables were identified using the least absolute shrinkage and selection operator regression. In multivariable Cox regression, HCT was identified as an independent protective factor for 365-day all-cause mortality in patients with AHF (HR = 0.98, P = 0.004). The restricted cubic spline curve revealed a nonlinear relationship between the 2 (P nonlinear = 0.002), with inflection points at 30. According to the threshold effect analysis of HCT on mortality, patients in the low HCT group had a significantly higher mortality rate (HR = 0.92, P = 0.001). Finally, subgroup analysis revealed no interaction (P > 0.05).A negative association exists between HCT and 365-day all-cause mortality in patients with AHF. Low HCT (< 30%) was significantly associated with a higher mortality rate in patients with AHF.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 1","pages":"35-42"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Improvement of Students' Interest in Cardiology during Bedside Learning Is Associated with the Future Selection of the Cardiology Specialty.","authors":"Teruhiko Imamura","doi":"10.1536/ihj.25-674","DOIUrl":"https://doi.org/10.1536/ihj.25-674","url":null,"abstract":"<p><p>Japan is facing a growing demand for cardiology care, while the recruitment of new cardiologists remains insufficient. This study investigated whether improvement of medical students' interest in cardiology during bedside learning predicts subsequent selection of cardiology as a specialty after residency.This retrospective cohort study included fifth-year medical students who completed a cardiology bedside learning internship at a rural Japanese university hospital. Interest in cardiology was assessed using a five-point Likert scale before and after the internship. Improvement of interest - defined as upward transition or persistent strong interest - was used as the key independent variable. Its predictive ability upon specialty selection following the two-year residency (approximately three years later) was evaluated.Among 197 eligible students, 143 were included in the final analysis. Overall, interest in cardiology significantly increased following bedside learning (P = 0.001). Fifty-two students demonstrated improved interest. Nine students (6%) ultimately selected cardiology as their specialty, including seven with improved interest and two without. Improved interest was moderately predictive of cardiology specialty selection (area under the curve 0.72), and was significantly associated with specialty choice (adjusted odds ratio 6.24; 95% confidence interval 1.27-32.5; P = 0.025).Increased interest in cardiology during bedside learning was associated with subsequent selection of cardiology as a specialty. Optimal bedside learning to increase interest in cardiology and cardiology specialist recruitment remains the next concern.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 2","pages":"142-149"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty Modifies the Predictive Capacity of the Triglyceride-Glucose Index for Coronary Heart Disease.","authors":"Peng Gao, Chunlei Li, Ran Liu, Wenming Chen, Guangyao Zhai","doi":"10.1536/ihj.25-460","DOIUrl":"https://doi.org/10.1536/ihj.25-460","url":null,"abstract":"<p><p>Coronary heart disease (CHD) significantly contributes to global mortality, particularly in frail populations. This study investigated how frailty affects the predictive capacity of the triglyceride-glucose (TyG) index for CHD.Analysis of 8,080 participants utilized the TyG Index (high ≥ 8.697) and Frailty Index (frail ≥ 0.21). Logistic regression and restricted cubic spline analyses assessed the relationships between TyG and CHD.In non-frail individuals, TyG independently predicted CHD (OR = 1.89, 95% CI: 1.42-2.51) with a near-linear relationship. In frail populations, TyG lost predictive independence and showed a U-shaped relationship. Frailty significantly moderated the TyG-CHD association (P_interaction = 0.036).Frailty substantially influences the predictive value of TyG for CHD. While TyG reliably predicts CHD in non-frail individuals, its utility diminishes in frail populations, highlighting the importance of incorporating frailty in CHD risk assessments.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 2","pages":"123-131"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}