Journal of cardiology最新文献

{"title":"Current status and future perspective of coronary artery calcium score in asymptomatic individuals.","authors":"Yuko O Kawaguchi, Shinichiro Fujimoto, Yui O Nozaki, Nobuo Tomizawa, Hiroyuki Daida, Tohru Minamino","doi":"10.1016/j.jjcc.2024.11.008","DOIUrl":"10.1016/j.jjcc.2024.11.008","url":null,"abstract":"<p><p>Atherosclerotic cardiovascular disease remains a major cause of death, and it is important to accurately estimate the cardiovascular events risk stratification even in asymptomatic patients. The coronary artery calcium score (CACS), which is quantitatively evaluated by electrocardiogram (ECG)-gated non-contrast chest computed tomography (CT) imaging, has been reported to be useful for cardiovascular event risk stratification in large studies. In the USA and Europe, guidelines recommend the use of the CACS in borderline or intermediate-risk asymptomatic individuals based on a high level of evidence. In Japan, however, the use of CACS in clinical practice is currently limited. Although it has been reported that the prevalence and distribution of coronary artery calcification (CAC) may differ by race and ethnicity, there are few data on its usefulness in stratifying the risk of cardiovascular events in asymptomatic Japanese individuals. While it is important to establish evidence for the usefulness of CACS in the Japanese population, for widespread clinical dissemination it would be beneficial to evaluate CAC and to perform accurate cardiovascular event risk stratification from non-ECG-gated non-contrast chest CT imaging performed during medical check-up and routine clinical practice. There have been reports on the usefulness of CAC assessed by non-ECG-gated chest CT imaging and on the relationship of CAC between ECG-gated and non-ECG-gated chest CT imaging. In recent years, a more accurate method of evaluating CACS from non-ECG-gated chest CT imaging has been developed using artificial intelligence, and further development is expected in the future.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in clinical practice for wild-type transthyretin amyloid cardiomyopathy from Kochi amyloidosis cohort: Impact of a new guideline and diagnosis and treatment strategy in Japan.","authors":"Yuri Ochi, Toru Kubo, Yuichi Baba, Kazuya Miyagawa, Tatsuya Noguchi, Takayoshi Hirota, Naohito Yamasaki, Hiroaki Kitaoka","doi":"10.1016/j.jjcc.2024.11.011","DOIUrl":"10.1016/j.jjcc.2024.11.011","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-specific differences of Impella support in Japanese patients: The Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD) registry analysis on outcomes and adverse events.","authors":"Akihiro Shirakabe, Masato Matsushita, Shota Shigihara, Suguru Nishigoori, Tomofumi Sawatani, Kenichi Tani, Masaki Morooka, Kuniya Asai","doi":"10.1016/j.jjcc.2024.11.007","DOIUrl":"10.1016/j.jjcc.2024.11.007","url":null,"abstract":"<p><strong>Background: </strong>The association between the clinical significance and prognostic impact of catheter-based micro-axial ventricular assist device Impella (Abiomed, Danvers, MA, USA) support and age has not been sufficiently investigated.</p><p><strong>Methods and results: </strong>A total of 5282 patients treated with Impella were analyzed from the Japanese registry for Percutaneous Ventricular Assist Device (J-PVAD). Patients were categorized into four age groups: <50 years old (Group A, n = 670), 50-69 years old (Group B, n = 2009), 70-79 years old (Group C, n = 1716), and ≥80 years old (Group D, n = 887). Kaplan-Meier curve analysis demonstrated that the prognosis, including 30-day all-cause mortality, was significantly poorer in Group D compared to the other groups. A multivariate Cox regression model identified Group D as an independent predictor of 30-day all-cause death (HR: 2.173, 95 % CI: 1.699-2.779) relative to Group A. The multivariate logistic regression analysis indicated that estimated glomerular filtration rate, lactate levels, and systolic blood pressure were independently associated with 30-day mortality across all age categories. The presence of more than two major adverse events was independently associated with 30-day mortality specifically in the cohort aged ≥80 years (OR: 1.492, 95 % CI: 1.037-2.148, p = 0.031).</p><p><strong>Conclusion: </strong>Increasing age was identified as a significant factor associated with higher 30-day mortality rates in J-PVAD. While the incidence of major adverse events did not differ significantly across age categories, the occurrence of two or more additional adverse events was linked to increased 30-day mortality among older individuals. Therefore, an appropriate mechanical support strategy may be necessary for elderly Japanese patients based on their age.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital therapeutics in Japan: Present and future directions.","authors":"Akihiro Nomura","doi":"10.1016/j.jjcc.2024.11.005","DOIUrl":"10.1016/j.jjcc.2024.11.005","url":null,"abstract":"<p><p>Digital therapeutics (DTx) represent an innovative approach to healthcare, leveraging software applications (apps) delivered through digital devices to treat medical conditions. This review focuses on three DTx apps approved in Japan, targeting nicotine dependence, hypertension, and insomnia. CureApp SC, the DTx system for nicotine dependence, comprises a patient smartphone app, an Internet of Things device for exhaled carbon monoxide measurement, and a Web-based physician app. A clinical trial demonstrated significantly higher rates of continuous abstinence in the intervention group than in the controls (63.9 % vs. 50.5 %, p = 0.001) at 24 weeks, with effects persisting through 52 weeks. For hypertension management, CureApp HT focuses on lifestyle modifications with daily home blood pressure monitoring. The HERB-DH1 trial showed a significant reduction in 24-h systolic blood pressure (between-group difference, -2.4 mmHg; p = 0.024) and morning home blood pressure (between-group difference, -4.3 mmHg; p < 0.001) in the intervention group compared with those in the controls. This hypertension DTx app also exhibits potential lifetime cost-effectiveness. Regarding insomnia management, SUSMED MedCBT-i supports physician-delivered cognitive behavioral therapy for insomnia. In a randomized controlled trial, Athens Insomnia Scale scores significantly improved in the intervention group compared with those in the controls (between-group difference, -3.4 point; p < 0.001) at 8 weeks. These DTx apps represent a significant advancement in managing chronic conditions, offering scalable and accessible methods for delivering evidence-based interventions. They also address the challenges in implementing lifestyle modifications and behavioral therapies in traditional healthcare settings. As DTx become more integrated into routine clinical practice, ongoing research is crucial to evaluate their long-term efficacy, safety, and cost-effectiveness. The success of these initial DTx apps in Japan paves the way for more comprehensive digital health solutions, potentially improving individual patient outcomes and contributing to larger-scale public health improvements in managing chronic conditions.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of tafamidis therapy on physical function in patients with wild-type transthyretin cardiac amyloidosis.","authors":"Atsushi Shibata, Yasuhiro Izumiya, Toshitake Yoshida, Akiko Tanihata, Ryoko Kitada, Kenichiro Otsuka, Asahiro Ito, Takanori Yamazaki, Daiju Fukuda","doi":"10.1016/j.jjcc.2024.11.004","DOIUrl":"10.1016/j.jjcc.2024.11.004","url":null,"abstract":"<p><strong>Background: </strong>Tafamidis is used as disease-modifying treatment for patients with wild-type transthyretin cardiac amyloidosis (ATTRwt CA). However, the effects of tafamidis on exercise tolerance are unclear.</p><p><strong>Methods: </strong>This single-center, prospective, observational study aimed to assess the effect of tafamidis on exercise tolerance in 36 patients with ATTRwt CA. Exercise tolerance was evaluated by the peak oxygen uptake (peak VO₂) measured by the cardiopulmonary exercise test (CPX).</p><p><strong>Results: </strong>The baseline CPX showed a mean anaerobic threshold value of 11.6 ± 2.2 ml/kg/min and peak VO₂ of 15.6 ± 4.1 ml/kg/min. Twenty-eight of the 36 patients underwent a follow-up CPX after 6 months. There was no significant change in peak VO₂ before and 6 months after tafamidis therapy (16.0 ± 4.2 vs. 14.7 ± 4.0 ml/kg/min). The baseline CPX data showed that the mean peak VO₂ was significantly lower in the increased peak VO₂ group than in the non-increased peak VO₂ group (13.7 ± 3.1 vs. 17.7 ± 4.1 ml/kg/min, p = 0.008). A multivariate logistic regression analysis showed that the baseline peak VO₂ value was an independent predictor of improved exercise tolerance by tafamidis therapy (odds ratio: 0.646, 95 % confidence interval: 0.449-0.930, p = 0.019).</p><p><strong>Conclusions: </strong>Tafamidis prevents deterioration of exercise tolerance in patients with ATTRwt CA. In some patients with ATTRwt CA, exercise tolerance may improve with the use of tafamidis, and those with lower exercise tolerance before tafamidis administration are likely to show improved exercise tolerance.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemonitoring in heart failure care: Does feasibility equate to clinical benefit?","authors":"Hamrish Kumar Rajakumar","doi":"10.1016/j.jjcc.2024.11.006","DOIUrl":"10.1016/j.jjcc.2024.11.006","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the efficacy of primary percutaneous coronary intervention in super-old and old aged patients in an advanced aging society.","authors":"Akihiro Endo, Tsuyoshi Oda, Kinya Shirota, Shintaro Akashi, Susumu Yamashita, Kazuhiko Uchida, Tetsuro Ohta, Yoshio Nakazawa, Kazuaki Tanabe","doi":"10.1016/j.jjcc.2024.11.002","DOIUrl":"10.1016/j.jjcc.2024.11.002","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines strongly recommend the application of primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction; however, information on its efficacy in super-old patients aged >90 years is inadequate. We compared the efficacy of primary PCI and its clinical outcomes in super-old patients with those of old patients in a super-aging society.</p><p><strong>Methods: </strong>Shimane Acute Coronary Syndrome (ACS) Registry was a multicenter retrospective cohort study. Consecutive patients with ACS who visited all PCI centers in Shimane Prefecture between January and December 2020 were enrolled. Patients were classified into four age categories: non-old (<65 years), pre-old (65-<75 years), old (75-<90 years), and super-old (≥90 years). Primary endpoints were major adverse cardiovascular events (MACE), including all-cause death, recurrent ACS, any stroke, and hospitalization for worsening heart failure.</p><p><strong>Results: </strong>In total, 454 patients were enrolled: 99 non-old, 124 pre-old, 181 old, and 50 super-old. The application rate of primary PCI decreased with increased age, with 89 % in old age and 78 % in super-old age (p = 0.042). In-hospital mortality rate was significantly higher in super-old age than in old age (22 % vs. 8 %, p = 0.010), particularly in shock cases (67 % vs. 31 %, p = 0.040); no difference was observed between the two groups in non-shock cases (8 % vs. 4 %, p = 0.259) or in cases that received primary PCI (10 % vs. 6 %, p = 0.232). Landmark analysis revealed that MACE after 30th day did not differ between super-old and old age groups.</p><p><strong>Conclusions: </strong>In the advanced aging society of Shimane Prefecture, more than half of patients with ACS were aged ≥75 years, with super-old patients aged ≥90 years accounting for 11 % of all patients. In-hospital mortality rate among super-old age patients was lower among those who underwent primary PCI. The prognosis for super-old age patients who were discharged alive was similar to that of old age patients.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of circumferential and longitudinal strain on left ventricle ejection fraction and myocardial surface area strain.","authors":"Dimitrios Ntelios, Anastasia Erythropoulou-Kaltsidou, Efstathios Pagourelias, Georgios Efthimiadis, Olivia Mauromoustaki, Vassilios Vassilikos","doi":"10.1016/j.jjcc.2024.11.001","DOIUrl":"10.1016/j.jjcc.2024.11.001","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' reply.","authors":"Anton Tomšič, Meindert Palmen","doi":"10.1016/j.jjcc.2024.10.005","DOIUrl":"10.1016/j.jjcc.2024.10.005","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of intraoperative color three-dimensional transesophageal echocardiography for detecting treatable residual mitral regurgitation immediately after mitral valve repair.","authors":"Takeshi Okubo, Keitaro Mahara, Kazuyuki Ozaki, Shuichiro Takanashi, Tomoki Shimokawa, Jun Umemura, Takayuki Inomata, Mitsuaki Isobe","doi":"10.1016/j.jjcc.2024.10.004","DOIUrl":"10.1016/j.jjcc.2024.10.004","url":null,"abstract":"<p><strong>Background: </strong>Residual mitral regurgitation (MR) immediately after mitral valve (MV) repair is a risk factor for late reintervention. This study aimed to determine the feasibility of color 3-dimensional intraoperative transesophageal echocardiography (3D-IOTEE) for clarifying the mechanism of residual MR and its impact on the conversion rate to MV replacement (MVR).</p><p><strong>Methods: </strong>Among 767 patients who underwent MV repair at our institute, 92 consecutive patients in whom an immediate second cardiopulmonary bypass (CPB) was performed due to MV repair for residual MR were evaluated. The patients were divided into the re-repair group [i.e. those in whom repair required additional procedures, n = 77 (83.7 %)] and the MVR group [i.e. patients who underwent MVR alone, n = 15 (16.3 %)]. All patients underwent 3D-IOTEE to evaluate the mechanisms of residual MR. The pathomechanisms were classified into the following five categories: Category 1, inter-scallop malcoaptation; Category 2, suture dehiscence; Category 3, prolapse; Category 4, systolic anterior motion of the MV; and Category 5, tethering. Clinical background and outcomes were compared between the two groups based on the five categories.</p><p><strong>Results: </strong>The rate of MVR conversion by etiology of residual MR after the first MV repair was 68.8 % (n = 11/16) in Category 1; 0 % (n = 0/22) in Category 2; 2.4 % (n = 1/41) in Category 3; 20 % (n = 2/10) in Category 4; and 33.3 % (n = 1/3) in Category 5. Among the 63 patients with Category 2 and 3 etiologies, 62 patients had complete MV re-repair with additional procedures [Category 2, 100 % (n = 22/22); Category 3, 97.6 % (n = 40/41)]. Meanwhile, MVR was performed owing to difficulty in MV repair after the second CPB in 11/16 patients (68.8 %) with Category 1 etiology.</p><p><strong>Conclusions: </strong>In the assessment of MR, 3D-IOTEE is useful for lesion localization and determining the origin and severity of MR, which are key factors in selecting the optimal surgical approach in patients undergoing re-repair.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}