International heart journal最新文献

{"title":"Prognostic Impact of Sarcopenia in Men Versus Women with Acute Decompensated Heart Failure and Preserved Left Ventricular Ejection Fraction.","authors":"Takanari Kimura, Shunsuke Tamaki, Takahisa Yamada, Tetsuya Watanabe, Masatake Fukunami, Yoshio Yasumura, Akito Nakagawa, Yusuke Nakagawa, Masamichi Yano, Takaharu Hayashi, Shungo Hikoso, Daisaku Nakatani, Yohei Sotomi, Yasushi Sakata","doi":"10.1536/ihj.24-475","DOIUrl":"10.1536/ihj.24-475","url":null,"abstract":"<p><p>Sarcopenia is associated with poor prognosis in chronic heart failure. The fat-free mass index (FFMI) is an indicator of resting energy expenditure and is used to clinically diagnose sarcopenia. We aimed to elucidate the prognostic impact of sarcopenia diagnosed via FFMI by sex in patients admitted for acute decompensated heart failure (ADHF) and preserved left ventricular ejection fraction (LVEF).Patients' data were extracted from the Prospective Multicenter Observational Study of Patients with Heart Failure with Preserved Ejection Fraction study, a prospective multicenter observational registry for patients with ADHF with LVEF ≥ 50% in Osaka. We studied 831 patients who survived and were discharged. Fat-free mass (FFM) was estimated using the Forbes formula (FFM [kg] = 7.38 + 0.02908 × urinary creatinine [mg/day]) and normalized to the square of the patient's height in meters to calculate the FFMI at discharge. Sarcopenia was defined as FFMI < 17 kg/m² in men and < 15 kg/m² in women.During the follow-up period of 3.3 ± 1.6 years, 351 patients died. Multivariate Cox analysis showed that sarcopenia was independently associated with all-cause mortality in women (P = 0.003) but not in men (P = 0.118) after adjustment for major confounders. Although sarcopenia was not associated with cardiac death in either sex, it was independently associated with noncardiac death in men (P = 0.048) and women (P < 0.001).Sarcopenia diagnosed via FFMI was associated with poor clinical outcomes in patients with ADHF and preserved LVEF, primarily attributable to its association with noncardiac death, regardless of sex.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 3","pages":"363-374"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199006","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":"A Randomized Controlled Study on the Clinical Efficacy of Ginkgo Biloba Combined with Nicorandil in Patients with HFmrEF.","authors":"Xiang Gao, Fangyuan Liu, Xiaozhen Han, Shan Tang, Dingding Shen, Jia Zhang, Chuanliang Liu","doi":"10.1536/ihj.24-316","DOIUrl":"10.1536/ihj.24-316","url":null,"abstract":"<p><p>This study aimed to explore the clinical efficacy of Ginkgo biloba combined with Nicorandil in patients with heart failure who have a mild decrease in ejection fraction (HFmrEF).A total of 316 patients with HFmrEF were selected and randomly assigned to either a control group or a combination of the Ginkgo biloba and Nicorandil group, each group consisting of 158 patients. The control group received standard secondary preventive treatment, while patients in the combination group received oral Ginkgo biloba and Nicorandil based on stable conventional treatment. Both groups were treated continuously for six months. The age, sex, body mass index (BMI), New York Heart Association cardiac function classification, history of coronary heart disease, hypertension, diabetes, atrial fibrillation, smoking, left ventricular ejection fractions (LVEF), heart rate, glycosylated hemoglobin (HbA1c), and combined drug use of the patients in the two groups were recorded. The efficacy endpoints were BMI, heart rate, blood lipid levels, fasting blood glucose, renal function, HbA1c, N-terminal pro-brain natriuretic peptide (NT-proBNP), LVEF, cardiopulmonary exercise testing parameters, 6-minute walking distance (6MWD), and the Kansas City Cardiomyopathy Questionnaire (KCCQ) score after six months of treatment. The incidence of adverse reactions in the two groups was recorded.After six months of treatment, the BMI, heart rate, NT-proBNP, low-density lipoprotein cholesterol, triglyceride, creatinine, fasting blood glucose, and HbA1c levels of patients in the Ginkgo biloba combined with Nicorandil group were lower than those in the control group (P < 0.05). The LVEF, high-density lipoprotein cholesterol, VO2peak, oxygen uptake efficiency slope, 6MWD, and KCCQ scores were higher in the Ginkgo biloba combined with Nicorandil group than in the control group (P < 0.05). There was no statistically significant difference between the two groups of patients (P > 0.05) in the incidence of hypotension, hypoglycemia, hypokalemia, headache, and hospitalization due to worsening heart failure.Ginkgo biloba combined with Nicorandil can effectively improve heart function, blood lipid levels, blood glucose levels, renal function, exercise tolerance, and health-related quality of life in patients with HFmrEF. Because there were no significant adverse reactions, they can be safely used.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 1","pages":"74-80"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079786","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":"Unrecognized Diversity in the Effects of Cardiac Rehabilitation by Age in Patients with Heart Failure.","authors":"Kohsaku Goto, Eisuke Amiya","doi":"10.1536/ihj.24-742","DOIUrl":"https://doi.org/10.1536/ihj.24-742","url":null,"abstract":"","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 1","pages":"1-2"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079499","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 High Care Unit Management on In-Hospital Mortality in Patients with ST-Elevation Myocardial Infarction.","authors":"Takaaki Asano, Yorihiko Koeda, Takahito Nasu, Reisuke Yoshizawa, Yu Ishikawa, Tomonori Itoh, Yoshihiro Morino, Hidenori Saito, Hiroyuki Onodera, Tetsuji Nozaki, Yuko Maegawa, Osamu Nishiyama, Mahito Ozawa, Takuya Osaki, Akihiro Nakamura","doi":"10.1536/ihj.24-720","DOIUrl":"10.1536/ihj.24-720","url":null,"abstract":"<p><p>The impact of HCU management on the short-term prognosis of STEMI patients undergoing primary percutaneous coronary intervention (PCI) remains unclear.We retrospectively assessed 694 STEMI patients who underwent primary PCI at 8 regional general hospitals in Iwate Prefecture from 2014-2018. The patients were categorized based on the hospital to which they were admitted with or without HCUs (353 versus 341 patients, from 3 versus 5 hospitals, respectively). There was no significant between-group difference for overall in-hospital mortality (7% versus 10%, P = 0.174). However, in the Killip Class II or higher, in-hospital mortality was significantly lower among patients admitted to the HCU (20% versus 44%, P < 0.001). After propensity score matching, we found that overall in-hospital mortality was significantly lower in patients admitted to HCUs (2% versus 8%, P = 0.008). Furthermore, mortality rates for patients requiring mechanical ventilation or circulatory support were significantly lower for patients admitted to HCUs, with mortality rates of 30% versus 50% (P = 0.037).Our findings suggest that in hospitals without CCUs, systemic management through HCUs may significantly improve the survival prognosis of STEMI patients with Killip classification of II or higher.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"226-233"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752312","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":"Association Between Hemodynamic Monitoring Need and Prognosis of Patients with Sepsis in the Intensive Care Unit.","authors":"Ruitong Zhou, Le Fu, Yide Li, Liang Luo","doi":"10.1536/ihj.24-601","DOIUrl":"https://doi.org/10.1536/ihj.24-601","url":null,"abstract":"<p><p>Sepsis, a life-threatening disease characterized by organ dysfunction, is primarily caused by an abnormally regulated host response to infection. This study aimed to evaluate the association between hemodynamic monitoring (HM) and the prognosis of patients with sepsis in the intensive care unit (ICU). This retrospective analysis used data from the MIMIC-IV database (2008-2019) at a tertiary medical center in Boston, focusing on adult patients with sepsis. Hemodynamic monitoring was conducted using PICCO. The primary outcome was in-hospital mortality, and the secondary outcomes were ICU mortality, hospital stay, and ICU length of stay. In our study, 16,065 patients were selected for the cohort, and 109 of them underwent HM. After 1:1 matching using a genetic algorithm, the final matched cohort included 98 patients who received HM and 98 patients who did not. The HM group had significantly higher hospital (38.64% versus 14.77%, P < 0.001) and ICU mortality (32.6% versus 17.35%, P < 0.001). In conclusion, patients with sepsis who underwent HM had a worse prognosis. The association between HM and higher mortality rates necessitates further research to understand the underlying reasons and to optimize the use of HM strategies in sepsis management in the ICU.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 3","pages":"436-442"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199000","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":"Successful Cryoballoon Ablation in Paroxysmal Atrial Fibrillation Patient Post-Esophageal Cancer Surgery.","authors":"Yuji Miyoshi, Shota Tokuno, Yasuko Tanabe, Yuichiro Kawamura, Naoki Nakagawa","doi":"10.1536/ihj.24-541","DOIUrl":"10.1536/ihj.24-541","url":null,"abstract":"<p><p>In conventional radiofrequency ablation for symptomatic paroxysmal atrial fibrillation, there are concerns regarding the risk of esophageal thermal injury (ETI), such as esophageal ulcers and left atrioesophageal fistulas. While the incidence of ETI is generally considered low with cryoballoon ablation, some cases of esophageal ulcers and gastric hypoperistalsis have been reported. In this report, we present the case of a 77-year-old male patient with atrial fibrillation after esophageal surgery who had successfully undergone cryoballoon ablation without esophageal complications, despite the close proximity of the left atrium and gastric tube. Cryoballoon ablation achieved pulmonary vein isolation without complications in the upper alimentary tract.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 1","pages":"183-186"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079434","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":"Concomitant Mitral Valve Surgery in a Modified Morrow Procedure in Patients with Hypertrophic Obstructive Cardiomyopathy.","authors":"Chunshui Liang, Mingwen Li, Ruiyan Ma, Zhao Jian","doi":"10.1536/ihj.24-155","DOIUrl":"10.1536/ihj.24-155","url":null,"abstract":"<p><p>Ventricular septal myectomy (modified Morrow procedure) is the gold standard surgical intervention for hypertrophic obstructive cardiomyopathy (HOCM). However, the indications for a concomitant mitral valve (MV) procedure to relieve mitral regurgitation (MR) or intrinsic MV pathological changes remain controversial. We aimed to retrospectively analyze this series of patients to evaluate the safety and efficiency of the procedure at our center.We retrospectively reviewed a total of 56 consecutive patients with HOCM who underwent concomitant MV surgery with modified Morrow procedures at our center between January 2019 and December 2021. The baseline characteristics, perioperative data, and postoperative outcomes were examined.The operative mortality rate was 0% among all 56 patients. Two patients had complete atrioventricular block, two patients experienced renal failure, and one patient required reoperation for bleeding. The peak gradient of the left ventricular outflow tract decreased from 93.6 ± 34.4 mm Hg to 20.5 ± 13.0 mm Hg. MR was significantly relieved, and the systolic anterior motion of the MV resolved completely after concomitant MV surgery. During a mean follow-up of 13.8 ± 7.1 months, no patient required cardiac reoperation.Concomitant surgery of the MV during the modified Morrow procedure was performed safely and effectively in the treatment of most types of HOCM in our practice.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"252-256"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752614","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":"Coronary Microvascular Dysfunction and Adverse Outcomes in the Spectrum of Dilated Cardiomyopathy.","authors":"Hisanori Kosuge, Masatake Kobayashi, Shoko Hachiya, Yasuhiro Fujita, Satoshi Hida, Kazuhiro Satomi","doi":"10.1536/ihj.24-744","DOIUrl":"10.1536/ihj.24-744","url":null,"abstract":"<p><p>Hypokinetic non-dilated cardiomyopathy (HNDC), a preclinical state of dilated cardiomyopathy (DCM), is characterized by left ventricular (LV) dysfunction without LV dilatation. Although myocardial fibrosis and microvascular dysfunction in DCM are associated with LV remodeling and poor outcome, these characteristics concerning HNDC remain unclear. We compared DCM and HNDC with regard to their clinical characteristics and prognosis.We retrospectively enrolled 100 patients with DCM (n = 64) or HNDC (n = 36) who underwent cardiac magnetic resonance (CMR). DCM and HNDC were classified based on an LV end-diastolic diameter index (LVEDDI). The association of LVEDDI with the composite outcome of all-cause mortality, heart failure hospitalization, or ventricular arrhythmia occurrence was assessed. Phase-contrast cine imaging was performed in a subset of 17 patients (12 with DCM and 5 with HNDC) and 7 control subjects to assess coronary flow reserve (CFR).During the follow-up period (median: 22.0 months; interquartile range: 9.0-33.8 months), patients with DCM showed higher risk of the primary outcome than those with HNDC (P = 0.026). A higher LVEDDI was significantly associated with clinical outcomes even after adjusting for covariates (i.e., brain natriuretic peptide, the presence of late gadolinium enhancement, and LV ejection fraction; adjusted hazard ratio, 1.350; 95% confidence interval, 1.008-1.808; P = 0.044). CFR in HNDC was significantly higher than that in DCM (P < 0.05) and comparable to that in the control group.LV dilatation is an independent predictor of adverse events in DCM and HNDC.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"257-263"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752616","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":"Clinical Courses of Elderly Patients with Heart Failure Managed by Local Partnership Clinical Pathway and Multidisciplinary Care.","authors":"Yuki Yamamoto, Noboru Watanabe, Satoru Hasegawa, Chieko Tanaka, Chie Takano, Takahiro Shimizu, Hirohiko Motoki, Mitsuaki Isobe, Koichiro Kuwahara","doi":"10.1536/ihj.24-467","DOIUrl":"https://doi.org/10.1536/ihj.24-467","url":null,"abstract":"<p><p>Heart failure (HF) is the most critical issue in the medical and long-term care for the elderly because HF is an economic and social burden due to its high prevalence and poor prognosis. General practitioners (GPs) have recently managed patients with chronic HF (CHF) in collaboration with hospital cardiologists. However, little is known about how to collaborate and its outcomes.We have operated a local partnership program using clinical pathway (LPCP) for CHF to facilitate medical and nursing care teamwork in the local community since June 2009. The hospital's multidisciplinary teams evaluate and share patient information periodically. Among 500 patients with available follow-up data as of December 2020, we defined patients who withdrew from the LPCP for reasons other than death as path-dropout (n = 164) and the remaining as path-continue patients (n = 336). The Kaplan-Meier method considering time co-variability of path-dropout, showed a significantly higher hazard ratio of all-cause death in the path-dropout group than in the path-continue group (HR: 5.09; 95% CI: 3.54-7.30, P < 0.001).LPCP provides integrated disease management for CHF by cardiologists and multidisciplinary professionals in the hospital collaborating with local GPs and home care teams. A multivariate analysis identified LPCP as the most important independent predictor of clinical outcome. LPCP may work as an observational tool to distinguish HF patient clinical outcomes.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 3","pages":"352-362"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199001","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":"Risk Factors and Construction of a Predictive Model for Postoperative Early Cognitive Dysfunction in Aortic Dissecting Aneurysms.","authors":"Lu Ding, Yinhuan Xu, Guangpu Fan","doi":"10.1536/ihj.24-686","DOIUrl":"https://doi.org/10.1536/ihj.24-686","url":null,"abstract":"<p><p>This study aimed to investigate the factors influencing cognitive dysfunction in patients with aortic dissection after surgery and to construct a risk prediction model for it.This retrospective study analyzed 122 patients with aortic dissection who were admitted to our hospital between January 1, 2015, and February 29, 2024. First, we grouped the patients based on the early occurrence of postoperative cognitive dysfunction (POCD) after surgery into the POCD and non-POCD groups. We subsequently compared the general clinical data and relevant surgical information between the two groups. Multivariate binary logistic regression analysis was performed to identify the factors influencing early POCD in patients with aortic dissection. Then, the risk prediction model was constructed. Receiver operating characteristic (ROC) curves were used to analyze each factor's predictive effectiveness.Multivariate binary logistic regression analysis revealed that age at surgery (P = 0.042), intensive care unit (ICU) stay duration (P = 0.003), mechanical ventilation time (P = 0.020), and aortic cross-clamping time (P = 0.010) were independent risk factors for early POCD in patients with aortic dissection, while postoperative oxygen saturation (P < 0.001) acted as an independent protective factor. A predictive model was established, achieving a ROC curve, area under the curve of 0.955, 95% confidence interval (0.917, 0.993), sensitivity of 0.878, and specificity of 0.926.Age at surgery, ICU stay duration, mechanical ventilation time, aortic cross-clamping time, and postoperative oxygen saturation were independent influencing factors for predicting early POCD.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 3","pages":"456-462"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199008","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}