Circulation Journal最新文献

Reduced Pulmonary Artery Compliance in a Conscious State Predicts Cardiac Event After Transcatheter Edge-to-Edge Repair in Patients With Ventricular Secondary Mitral Regurgitation.

IF 3.1 3区医学

Circulation Journal Pub Date : 2025-02-05 DOI: 10.1253/circj.CJ-24-0541

Makoto Amaki, Shinichi Kurashima, Yuki Irie, Atsushi Okada, Soshiro Ogata, Shin Ito, Yu Kataoka, Hideaki Kanzaki, Takashi Kitai, Kazuhiro Yamamoto, Chisato Izumi

{"title":"Reduced Pulmonary Artery Compliance in a Conscious State Predicts Cardiac Event After Transcatheter Edge-to-Edge Repair in Patients With Ventricular Secondary Mitral Regurgitation.","authors":"Makoto Amaki, Shinichi Kurashima, Yuki Irie, Atsushi Okada, Soshiro Ogata, Shin Ito, Yu Kataoka, Hideaki Kanzaki, Takashi Kitai, Kazuhiro Yamamoto, Chisato Izumi","doi":"10.1253/circj.CJ-24-0541","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0541","url":null,"abstract":"Background: Right ventricular (RV) dysfunction negatively affects mitral valve transcatheter edge-to-edge repair (M-TEER) outcomes in patients with ventricular secondary mitral regurgitation (vSMR). However, RV dysfunction occurs in the late phase of heart failure, when it may not respond to interventions. The pulsatile component of RV afterload, pulmonary artery (PA) compliance, is a sensitive parameter that decreases before RV dysfunction occurs. We explored the utility of PA compliance in predicting cardiac events after M-TEER.Methods and results: We analyzed 107 patients with vSMR who underwent M-TEER and in whom right heart catheter parameters were measured in a conscious state. Twenty-four patients had a cardiac event. There were no differences in patient characteristics or echocardiographic parameters between groups with and without cardiac events. PA compliance was significantly reduced in the event group, but other RV function parameters did not differ between the 2 groups. Receiver operating characteristic curve analysis revealed an optimal prognostic cut-off value for PA compliance of 2.7 mL/mmHg. In multivariate Cox regression, reduced PA compliance (<2.7 mL/mmHg) was strongly associated with cardiac events. Kaplan-Meier analysis revealed PA compliance had significant prognostic power for the composite outcome of cardiac events (log-rank P<0.01).Conclusions: Reduced PA compliance (hemodynamically derived in the conscious state) was a strong prognostic indicator in patients with vSMR who underwent M-TEER.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257317","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}

引用次数: 0

Validity of HELT-E₂S₂ Score in Predicting Ischemic Stroke in Japanese Patients With Non-Valvular Atrial Fibrillation With Cardiac Implantable Electronic Devices.

IF 3.1 3区医学

Circulation Journal Pub Date : 2025-02-01 DOI: 10.1253/circj.CJ-24-0715

Miyo Nakano, Yusuke Kondo, Yuki Shiko, Masahiro Nakano, Takatsugu Kajiyama, Ryo Ito, Toshinori Chiba, Yutaka Yoshino, Satoko Ryuzaki, Yukiko Takanashi, Yuya Komai, Shoko Narumi, Yoshio Kobayashi

{"title":"Validity of HELT-E2S2 Score in Predicting Ischemic Stroke in Japanese Patients With Non-Valvular Atrial Fibrillation With Cardiac Implantable Electronic Devices.","authors":"Miyo Nakano, Yusuke Kondo, Yuki Shiko, Masahiro Nakano, Takatsugu Kajiyama, Ryo Ito, Toshinori Chiba, Yutaka Yoshino, Satoko Ryuzaki, Yukiko Takanashi, Yuya Komai, Shoko Narumi, Yoshio Kobayashi","doi":"10.1253/circj.CJ-24-0715","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0715","url":null,"abstract":"Background: The HELT-E2S2score, a novel risk stratification system, was developed to determine the incidence of ischemic stroke in Japanese patients with non-valvular atrial fibrillation (NVAF). It has been suggested that the HELT-E2S2score is more useful than the CHADS2and CHA2DS2-VASc scores for Japanese patients with NVAF. This study determined the incidence of ischemic stroke in patients with NVAF and cardiac implantable electronic devices (CIEDs) and assessed the validity of the HELT-E2S2score in this population.Methods and results: We retrospectively analyzed the database of the CIED clinic of Chiba University Hospital and investigated the incidence of ischemic stroke according to the HELT-E2S2score. Of the 730 consecutive patients who were followed-up at the CIED clinic, those without NVAF were excluded, leaving 362 patients in this study (mean [±SD] follow-up period, 64±48 months; mean age, 73±16 years; 65% male). The mean CHADS2and CHA2DS2-VASc scores were 1.8±1.2 and 2.8±1.6 points, respectively. During follow-up, 31 (8.6%) patients experienced ischemic stroke. The c-statistic for the HELT-E2S2score was 0.719 (95% confidence interval [CI] 0.657-0.795), which was higher than the c-statistics for the CHADS2(0.704; 95% CI 0.647-0.768; P=0.025) and CHA2DS2-VASc (0.700; 95% CI:0.621-0.747; P=0.0097) scores.Conclusions: Risk stratification for ischemic stroke using the HELT-E2S2score is valid in Japanese patients with NVAF and CIEDs.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081950","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}

引用次数: 0

Digitalomics: Towards Artificial Intelligence / Machine Learning-Based Precision Cardiovascular Medicine.

IF 3.1 3区医学

Circulation Journal Pub Date : 2025-01-31 DOI: 10.1253/circj.CJ-24-0865

Akihiro Nomura, Yasuaki Takeji, Masaya Shimojima, Masayuki Takamura

{"title":"Digitalomics: Towards Artificial Intelligence / Machine Learning-Based Precision Cardiovascular Medicine.","authors":"Akihiro Nomura, Yasuaki Takeji, Masaya Shimojima, Masayuki Takamura","doi":"10.1253/circj.CJ-24-0865","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0865","url":null,"abstract":"Recent advances in traditional \"-omics\" technologies have provided deeper insights into cardiovascular diseases through comprehensive molecular profiling. Accordingly, digitalomics has emerged as a novel transdisciplinary concept that integrates multimodal information with digitized physiological data, medical imaging, environmental data, electronic health records, environmental records, and biometric data from wearables. This digitalomics-driven augmented multiomics approach can provide more precise personalized health risk assessments and optimization when combined with conventional multiomics approaches. Artificial intelligence and machine learning (AI/ML) technologies, alongside statistical methods, serve as key comprehensive analytical tools in realizing this comprehensive framework. This review focuses on two promising AI/ML applications in cardiovascular medicine: digital phonocardiography (PCG) and AI text generators. Digital PCG uses AI/ML models to objectively analyze heart sounds and predict clinical parameters, potentially surpassing traditional auscultation capabilities. In addition, large language models, such as generative pretrained transformer, have demonstrated remarkable performance in assessing medical knowledge, achieving accuracy rates exceeding 80% in medical licensing examinations, although there are issues regarding knowledge accuracy and safety. Current challenges to the implementation of these technologies include maintaining up-to-date medical knowledge and ensuring consistent accuracy of outputs, but ongoing developments in fine-tuning and retrieval-augmented generation show promise in addressing these challenges. Integration of AI/ML technologies in clinical practice, guided by appropriate validation and implementation strategies, may notably advance precision cardiovascular medicine through the digitalomics framework.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081948","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}

引用次数: 0

Aortic Valve Stenosis-Like Symptoms Caused by Pseudoaneurysm Following Total Arch Replacement.

IF 3.1 3区医学

Circulation Journal Pub Date : 2025-01-31 DOI: 10.1253/circj.CJ-24-0918

Kazuhiro Ueno, Takashi Shuto, Kaoru Uchida, Shinji Miyamoto

引用次数: 0

Efficacy of Rheocarna^®, a Novel Apheresis Device, in Patients With No- or Poor-Option Chronic Limb-Threatening Ischemia.

IF 3.1 3区医学

Circulation Journal Pub Date : 2025-01-30 DOI: 10.1253/circj.CJ-24-0830

Yoshimitsu Soga, Mitsuyoshi Takahara, Yasutaka Yamauchi, Osamu Iida, Masahiko Fujihara, Daizo Kawasaki, Kazunori Horie, Amane Kozuki, Tatsuro Takei

{"title":"Efficacy of Rheocarna®, a Novel Apheresis Device, in Patients With No- or Poor-Option Chronic Limb-Threatening Ischemia.","authors":"Yoshimitsu Soga, Mitsuyoshi Takahara, Yasutaka Yamauchi, Osamu Iida, Masahiko Fujihara, Daizo Kawasaki, Kazunori Horie, Amane Kozuki, Tatsuro Takei","doi":"10.1253/circj.CJ-24-0830","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0830","url":null,"abstract":"Background: Although revascularization is first-line therapy for chronic limb-threatening ischemia (CLTI), there are no established treatments for patients in whom revascularization is not (or is a poor) option, including CLTI that has responded poorly to revascularization. This study verified the efficacy of the Rheocarna®, a novel apheresis device, for no-option CLTI or poor-response CLTI after revascularization.Methods and results: This multicenter retrospective observational study analyzed 221 patients (221 limbs) with no- or poor-option CLTI (mean [±SD] age 71±10 years; males, 70.1%; diabetes, 76.5%; dialysis, 87.8%; Rutherford category 6, 26.4%) undergoing apheresis with the Rheocarna between March 2021 and March 2022. The primary endpoint was the 1-year wound-healing rate. After apheresis with the Rheocarna, C-reactive protein, fibrinogen, and low-density lipoprotein cholesterol (LDL-C) levels decreased significantly, and the ankle-brachial index (ABI) and skin perfusion pressure (SPP) increased significantly (all P<0.05). At 1 year, the wound-healing rate was 60.7%, and rates of limb salvage, freedom from reintervention, overall survival, and amputation-free survival were 83.4%, 69.2%, 70.2% and 61.3%, respectively. At baseline, non-ambulatory status, lower ejection fraction, and lower blood albumin levels were independently associated with a lower wound-healing rate.Conclusions: Apheresis with the Rheocarna in patients with no- or poor-option CLTI reduced LDL-C and fibrinogen levels and improved ABI and SPP, achieving a 1-year wound healing rate of 60.7%. This novel approach could provide additional treatment options for conventional CLTI.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069425","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}

引用次数: 0

Decreased Homeostasis Model Assessment of β-Cell Function in Patients Without Diabetes Can Predict Future Events in Patients With Cardiovascular Disease.

IF 3.1 3区医学

Circulation Journal Pub Date : 2025-01-30 DOI: 10.1253/circj.CJ-24-0773

Yuma Ichikawa, Yosuke Watanabe, Koken Irie, Hiroshi Yokomichi, Takeo Horikoshi, Toru Yoshizaki, Juntaro Deyama, Kenji Kuroki, Manabu Uematsu, Tsuyoshi Kobayashi, Takamitsu Nakamura, Kazuto Nakamura, Akira Sato

{"title":"Decreased Homeostasis Model Assessment of β-Cell Function in Patients Without Diabetes Can Predict Future Events in Patients With Cardiovascular Disease.","authors":"Yuma Ichikawa, Yosuke Watanabe, Koken Irie, Hiroshi Yokomichi, Takeo Horikoshi, Toru Yoshizaki, Juntaro Deyama, Kenji Kuroki, Manabu Uematsu, Tsuyoshi Kobayashi, Takamitsu Nakamura, Kazuto Nakamura, Akira Sato","doi":"10.1253/circj.CJ-24-0773","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0773","url":null,"abstract":"Background: Reduced insulin secretion is linked to diabetes and cardiovascular disease (CVD), but its role in non-diabetic CVD patients is unclear. The homeostasis model assessment of β-cell function (HOMA-β) measures pancreatic β-cell function. This study investigated the association between HOMA-β and adverse cardiovascular events in non-diabetic CVD patients.Methods and results: This study included 1301 non-diabetic CVD patients who underwent cardiac catheterization at the University of Yamanashi Hospital. HOMA-β was calculated based on fasting blood glucose and insulin levels. Patients were followed for 3 years to track adverse events, such as all-cause death, myocardial infarction, angina pectoris requiring percutaneous coronary intervention, and heart failure. Receiver operating characteristic curve analysis established a HOMA-β cut-off value of ≤49.3%. Kaplan-Meier analysis indicated that patients with HOMA-β ≤49.3% had a significantly higher risk of adverse events (P <0.001), with a 2.65-fold increased risk (hazard ratio 2.65; 95% confidence interval 1.97-3.57). Adding HOMA-β to traditional risk factors such as age, sex, estimated glomerular filtration rate, and left ventricular ejection fraction significantly improved risk prediction, as demonstrated by net reclassification improvement and integrated discrimination improvement.Conclusions: Decreased HOMA-β is a significant predictor of adverse cardiovascular events in CVD patients without diabetes. These findings suggest reduced insulin secretion contributes to worse outcomes, underscoring the importance of monitoring HOMA-β in this population.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069422","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}

引用次数: 0

Patient Journey to Transthyretin Cardiac Amyloidosis Diagnosis　- A Japanese Claims Database Study.

IF 3.1 3区医学

Circulation Journal Pub Date : 2025-01-29 DOI: 10.1253/circj.CJ-24-0666

Masatoshi Minamisawa, Hiroaki Konishi, Yoshinobu Kitano, Hajime Abe, Kanae Togo, Yasuhiro Izumiya

{"title":"Patient Journey to Transthyretin Cardiac Amyloidosis Diagnosis　- A Japanese Claims Database Study.","authors":"Masatoshi Minamisawa, Hiroaki Konishi, Yoshinobu Kitano, Hajime Abe, Kanae Togo, Yasuhiro Izumiya","doi":"10.1253/circj.CJ-24-0666","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0666","url":null,"abstract":"Background: Transthyretin amyloid cardiomyopathy (ATTR-CM) is an under-recognized cause of heart failure (HF) in older adults. Delayed ATTR-CM diagnosis may result in more advanced symptoms. This study describes the journey of Japanese patients with ATTR-CM.Methods and results: This retrospective non-interventional study used the DeSC Healthcare database. Patients aged ≥18 years at the index date (date when ATTR-CM was first diagnosed or date of first tafamidis 80 mg prescription, whichever was earlier) and who had received ≥1 tafamidis 80 mg prescription or ≥1 specific ATTR-CM diagnosis, excepting \"suspected diagnosis\", at any time between April 1, 2014 and August 31, 2021 were included. The median age of patients was 79.0 years, and 79.9% (n=239) were male. The most frequently observed comorbidities defined as indicating the onset of ATTR-CM were HF (87.9%), atrial fibrillation/atrial flutter (50.2%), and conduction disorders (17.2%), with a median time from onset to index date of 15.5, 14.0, and 9.0 months for each comorbidity, respectively. Lumbar spinal stenosis (23.9%), neuropathy (13.0%), and carpal tunnel syndrome (7.5%) were common extracardiac symptoms, with a median time from the appearance of these symptoms to index date of 19.0, 5.0, and 18.0 months, respectively.Conclusions: There was a delay between the appearance of cardiac and extracardiac comorbidities of ATTR-CM and its diagnosis in real-world Japanese clinical settings, emphasizing the need for early diagnosis of ATTR-CM.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069429","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}

引用次数: 0

Current Status and Prospects of Regional Collaborative Pathways for Management of Acute Coronary Syndrome in Japan　- A Nationwide Survey.

IF 3.1 3区医学

Circulation Journal Pub Date : 2025-01-28 DOI: 10.1253/circj.CJ-24-0714

Yoshiyasu Minami, Yuji Ikari, Mutsuo Harada, Hiroshi Suzuki, Kazuki Fukui, Junya Ako, Yoshihiro J Akashi, Kiyoshi Hibi, Norihiko Kamioka, Masashi Koga, Kazuma Tashiro, Masaomi Gohbara, Kenji Onoue, Yoshihiko Saito, Issei Komuro

{"title":"Current Status and Prospects of Regional Collaborative Pathways for Management of Acute Coronary Syndrome in Japan　- A Nationwide Survey.","authors":"Yoshiyasu Minami, Yuji Ikari, Mutsuo Harada, Hiroshi Suzuki, Kazuki Fukui, Junya Ako, Yoshihiro J Akashi, Kiyoshi Hibi, Norihiko Kamioka, Masashi Koga, Kazuma Tashiro, Masaomi Gohbara, Kenji Onoue, Yoshihiko Saito, Issei Komuro","doi":"10.1253/circj.CJ-24-0714","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0714","url":null,"abstract":"Background: Comprehensive management of acute coronary syndrome (ACS) requires seamless treatment across institutions, including intensive care centers and local clinics. However, maintaining guideline-directed medical therapy remains challenging. One promising option to improve the situation may be the implementation of regional collaborative clinical pathways. This study evaluated the prevalence and functionality of such pathways for ACS in Japan.Methods and results: A nationwide survey was conducted through questionnaires and web searches, targeting all 47 prefectural managers of Japanese Circulation Association (JCA) branches. The study focused on pathways managed at the prefectural or regional levels, excluding inactive or institutional pathways. In all, 18 pathways were identified: 11 (23%) prefecture wide and 4 (9%) region wide. Most pathways included risk factor targets such as low-density lipoprotein cholesterol (LDL-C), HbA1c, and blood pressure, but only 8 pathways set an LDL-C target of <70 mg/dL. Pathways updated between 2022 and 2024 and incorporating LDL-C management protocols were considered functional. In all, 45 JCA branches viewed future ACS pathways established by the government or academic societies as potentially useful resources.Conclusions: Regional collaborative clinical pathways for ACS patients in Japan show variable implementation across prefectures, with approximately one-third of prefectures having established pathways. Future efforts should prioritize the establishment of comprehensive, sustainable, and standardized pathways to optimize ACS management and improve patient outcomes nationwide.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069420","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}

引用次数: 0

Association Between Cannula Size of Extracorporeal Membrane Oxygenation and Prognosis in Patients With Out-of-Hospital Cardiac Arrest　- A Secondary Analysis of the SAVE-J II Study.

IF 3.1 3区医学

Circulation Journal Pub Date : 2025-01-25 DOI: 10.1253/circj.CJ-24-0442

Marina Arai, Takahiro Nakashima, Teruo Noguchi, Toru Hifumi, Akihiko Inoue, Tetsuya Sakamoto, Yasuhiro Kuroda, Yoshio Tahara

{"title":"Association Between Cannula Size of Extracorporeal Membrane Oxygenation and Prognosis in Patients With Out-of-Hospital Cardiac Arrest　- A Secondary Analysis of the SAVE-J II Study.","authors":"Marina Arai, Takahiro Nakashima, Teruo Noguchi, Toru Hifumi, Akihiko Inoue, Tetsuya Sakamoto, Yasuhiro Kuroda, Yoshio Tahara","doi":"10.1253/circj.CJ-24-0442","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0442","url":null,"abstract":"Background: Selecting an appropriate cannula size is crucial for achieving an adequate extracorporeal membrane oxygenation (ECMO) flow rate. However, the association between ECMO cannula size and the prognosis of patients with out-of-hospital cardiac arrest (OHCA) has not been fully elucidated. We examined the associations between ECMO cannula size and neurological outcomes and survival at discharge in patients with OHCA who received ECMO.Methods and results: This is a secondary analysis of the Study of Advanced life support for Ventricular fibrillation with Extracorporeal circulation in Japan (SAVE-J II study). The primary and secondary outcomes were favorable neurological outcomes and survival at discharge, respectively. In all, 918 patients were included in the analysis. There were no statistically significant differences between cannula sizes and neurological outcomes. Multivariable analysis showed that increasing body weight (BW)-adjusted sizes of arterial cannulas (odds ratio [OR] 1.04 per 0.01-Fr/kg increase; 95% confidence interval [CI] 1.01-1.07; P=0.011) and venous cannulas (OR 1.04 per 0.01-Fr/kg increase; 95% CI 1.01-1.06; P=0.005) were significantly associated with the survival rate at discharge. Increasing BW-adjusted sizes of arterial cannulas were significantly associated with cannulation site bleeding.Conclusions: There were no significant associations between favorable neurological outcomes and cannula size, whereas larger-sized arterial and venous cannulas were significantly associated with higher survival rates at discharge in patients with OHCA who received ECMO.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047517","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}

引用次数: 0

Suspected Fatal Arrhythmic Events in Japanese Patients With Coronary Artery Disease　- From the CREDO-Kyoto PCI/CABG Registries Cohorts-2 and -3. 日本冠状动脉疾病患者的疑似致命性心律失常事件--来自 CREDO-Kyoto PCI/CABG 登记组群-2 和-3。

IF 3.1 3区医学

Circulation Journal Pub Date : 2025-01-25 DOI: 10.1253/circj.CJ-24-0488

Koji Hanazawa, Hiroki Shiomi, Takeshi Morimoto, Kenji Ando, Yutaka Furukawa, Tomohisa Tada, Junichi Tazaki, Kazushige Kadota, Toshihiro Tamura, Yukihito Sato, Mitsuo Matsuda, Moriaki Inoko, Manabu Shirotani, Tomoya Onodera, Eiji Shinoda, Takashi Yamamoto, Takashi Tamura, Shinji Miki, Takeshi Aoyama, Satoru Suwa, Kenji Minatoya, Yoshiharu Soga, Tadaaki Koyama, Tatsuhiko Komiya, Nobuhisa Ohno, Tatsuya Ogawa, Fumio Yamazaki, Junichiro Nishizawa, Jiro Esaki, Naoki Kanemitsu, Yoshihisa Nakagawa, Takeshi Kimura

{"title":"Suspected Fatal Arrhythmic Events in Japanese Patients With Coronary Artery Disease　- From the CREDO-Kyoto PCI/CABG Registries Cohorts-2 and -3.","authors":"Koji Hanazawa, Hiroki Shiomi, Takeshi Morimoto, Kenji Ando, Yutaka Furukawa, Tomohisa Tada, Junichi Tazaki, Kazushige Kadota, Toshihiro Tamura, Yukihito Sato, Mitsuo Matsuda, Moriaki Inoko, Manabu Shirotani, Tomoya Onodera, Eiji Shinoda, Takashi Yamamoto, Takashi Tamura, Shinji Miki, Takeshi Aoyama, Satoru Suwa, Kenji Minatoya, Yoshiharu Soga, Tadaaki Koyama, Tatsuhiko Komiya, Nobuhisa Ohno, Tatsuya Ogawa, Fumio Yamazaki, Junichiro Nishizawa, Jiro Esaki, Naoki Kanemitsu, Yoshihisa Nakagawa, Takeshi Kimura","doi":"10.1253/circj.CJ-24-0488","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0488","url":null,"abstract":"Background: Fatal arrhythmic events (FAEs), such as sudden cardiac death (SCD) and fatal ventricular arrhythmias, are a devastating complication in patients with coronary artery disease (CAD). Therefore, in this study we aimed to assess the incidence of FAEs in more recent Japanese patients with CAD and to examine whether risk stratification of FAEs can still be feasible using the left ventricular ejection fraction (LVEF).Methods and results: In the CREDO Kyoto PCI/CABG registry cohorts-2 and -3, there were 25,843 patients with LVEF data who received a first coronary revascularization (LVEF ≤35% group: N=1,671, 35%<LVEF≤40% group: N=1,075, 40%<LVEF≤45% group: N=1,594, and LVEF >45%: N=21,503). FAEs were defined as a composite of SCD or hospitalization for serious ventricular arrhythmias. The cumulative 5-year incidence of FAEs was 2.4% and it increased with decreasing LVEF (LVEF ≤35%: 8.84%, 35%<LVEF≤40%: 6.99%, 40%<LVEF≤45%: 4.49%, and LVEF >45%: 1.67%, log-rank P<0.0001). The adjusted risk of FAEs also increased with decreasing LVEF.Conclusions: LVEF is still a strong independent factor for predicting FAEs in patients with CAD in the PCI era. There was no obvious decrease in the incidence of FAEs between the 2 cohorts. The risk factors for FAEs through the 2 cohorts, other than low LVEF, included age ≥75 years, diabetes, heart failure, hemodialysis, atrial fibrillation, and anemia.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047519","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}

引用次数: 0