Circulation Journal最新文献

{"title":"Impact of Chronic Cibenzoline Therapy on Left Ventricular Remodeling in Patients With Hypertrophic Non-Obstructive Cardiomyopathy.","authors":"Mareomi Hamada, Akiyoshi Ogimoto, Takashi Otani, Shuntaro Ikeda, Yuji Shigematsu","doi":"10.1253/circj.CJ-24-0679","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0679","url":null,"abstract":"<p><strong>Background: </strong>Changes in left ventricular (LV) remodeling, especially in relation to the duration of therapy, are poorly understood in patients with hypertrophic non-obstructive cardiomyopathy (HNCM).</p><p><strong>Methods and results: </strong>This study included 254 consecutive patients with HNCM. Patients were divided into 3 groups according to the length of chronic cibenzoline therapy (CCT): Group I (n=104), CCT ≥10 years; Group II (n=85), 5 years≤CCT<10 years; and Group III (n=65), 1 year ≤CCT<5 years. SV1+RV5 and the maximum depth of precordial negative T waves were measured on electrocardiograms (ECG). In addition to routine echocardiographic indices, we measured the distance between the mitral valve and the apex (i.e., the \"LV long distance\" [LVLD]). After CCT, ECG indices and LV wall thicknesses were decreased in all 3 groups. LV dimensions and LV fractional shortening were preserved, and did not differ significantly among the groups. Left atrial dimension and the E/A ratio also did not differ among the groups, whereas the E/early diastolic annular velocity (Ea) ratio was decreased in Groups I and II. After CCT, LVLD was increased in all groups (all P<0.0001). These improvements were greater in Group I than in Groups II and III.</p><p><strong>Conclusions: </strong>CCT preserved LV systolic function and reduced LV hypertrophy in patients with HNCM. The E/Ea ratio was improved in Groups I and II. Thus, CCT aids in treating patients with HNCM.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659454","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":"High Level of Estimated Small Dense Low-Density Lipoprotein Cholesterol as an Independent Risk Factor for the Development of Ischemic Heart Disease Regardless of Low-Density Lipoprotein Cholesterol Level　- A 10-Year Cohort Study.","authors":"Keisuke Endo, Marenao Tanaka, Tatsuya Sato, Masafumi Inyaku, Kei Nakata, Wataru Kawaharata, Hiroki Aida, Itaru Hosaka, Yukinori Akiyama, Nagisa Hanawa, Masato Furuhashi","doi":"10.1253/circj.CJ-24-0770","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0770","url":null,"abstract":"<p><strong>Background: </strong>We previously reported that a high level of small dense low-density lipoprotein cholesterol (sdLDL-C) calculated by the Sampson equation was independently associated with the development of ischemic heart disease (IHD), but it remains unclear whether the effect depends on the level of low-density lipoprotein cholesterol (LDL-C).</p><p><strong>Methods and results: </strong>We investigated the associations of new onset of IHD with categorized groups of high (H-) and low (L-) levels of estimated sdLDL-C and LDL-C using 25^thpercentile levels of sdLDL-C level (25.2 mg/dL) and LDL-C (100 mg/dL) as cutoff values in 17,963 Japanese individuals (men/women: 11,508/6,455, mean age: 48 years) who underwent annual health checkups. During a 10-year follow-up period, 570 subjects (men/women: 449/121) had new development of IHD. Multivariable Cox proportional hazard analyses after adjustment of age, sex, smoking habit, hypertension and diabetes mellitus at baseline showed that the hazard ratio (HR) [95% confidence interval (CI)] for new onset of IHD was significantly higher in subjects with H-sdLDL-C/H-LDL-C (1.49 [1.06-2.08]) and subjects with H-sdLDL-C/L-LDL-C (1.49 [1.00-2.22]) than in subjects with L-sdLDL-C/L-LDL-C as the reference.</p><p><strong>Conclusions: </strong>A high level of sdLDL-C estimated by the Sampson equation was a predominant predictor for the development of IHD, regardless of the level of LDL-C, in a general Japanese population.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639868","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":"Utilization of Intensive Care Units and Outcomes Based on Admission Wards in Cardiovascular Emergencies.","authors":"Masanari Kuwabara, Takeshi Yamamoto, Yoshio Tahara, Migaku Kikuchi, Hiroshi Imamura, Ichiro Takeuchi, Naoki Sato, Tomonori Itoh, Yoko Sumita, Yoshihiro Miyamoto, Shiro Ishihara, Kikuo Isoda, Tomoko Ishizu, Takanori Ikeda, Hiroyuki Okura, Yoshio Kobayashi, Kuniya Asai","doi":"10.1253/circj.CJ-24-1043","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-1043","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular emergencies often require intensive care unit (ICU) management, but there is limited data comparing outcomes based on the admission ward.</p><p><strong>Methods and results: </strong>We analyzed data from the Japanese Registry of All Cardiac and Vascular Diseases Diagnosis Procedure Combination (JROAD-DPC) database (2016-2020) for 715,054 patients (mean age, 75.4±14.2 years, 58.4% male) admitted with acute myocardial infarction (N=175,974), unstable angina (N=45,308), acute heart failure (N=179,871), acute aortic dissection (N=58,597), pulmonary embolism (N=17,009), or post-cardiac arrest (N=184,701). Patients were categorized into 4 groups: intensive care add-ons 1/2, 3/4 (ICU 1/2, 3/4), high-care unit (HCU), and general wards. Comparisons included patient characteristics, hospitalization duration, mortality rates, and rates of defibrillation or cardiopulmonary resuscitation (CPR) defined by chest compression. General ward patients were the oldest and with shortest hospitalization durations. Additionally, mortality rates were the highest in general wards for acute heart failure, myocardial infarction, and aortic dissection. Defibrillation rates were 7.0%, 5.6%, 3.1%, and 4.3%, for ICU 1/2, 3/4, HCU, and general ward, respectively, with corresponding mortality rates of 40.4%, 44.1%, 44.6%, and 79.3%. CPR rates were 10.1%, 9.5%, 6.2%, and 3.1%, with mortality rates of 71.0%, 73.9%, 78.4%, and 97.7%, respectively.</p><p><strong>Conclusions: </strong>High mortality rates in general wards highlight the importance of ICU management, particularly for acute myocardial infarction and aortic emergencies. These findings support prioritizing ICU admission for these critical conditions.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639872","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":"Investigation of the Effect of Empagliflozin on Cardiac Sympathetic and Parasympathetic Nerve Activity Analyzed From Heart Rate Variability Frequency in Japanese Patients With Type 2 Diabetes　- Results From the EMPYREAN Study.","authors":"Hirohiko Motoki, Izuru Masuda, Koji Oba, Shinji Yasuno, Yoshito Inobe, Nobuyuki Azuma, Masako Waki, Takeshi Kimura, Wataru Shoin, Koji Yoshie, Masatoshi Minamisawa, Tomoaki Mochidome, Eiichiro Mawatari, Mitsuaki Horigome, Megumi Koshikawa, Kazuya Yamamoto, Terumoto Fukuchi, Toshiki Fukui, Hideki Chusho, Shinya Hiramitsu, Masanori Nishino, Masako Nakano, Sadao Nakajima, Koichiro Kuwahara","doi":"10.1253/circj.CJ-24-0799","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0799","url":null,"abstract":"<p><strong>Background: </strong>The EMPA-REG OUTCOME trial confirmed empagliflozin reduced mortality and heart failure hospitalization risk. These findings raised the possibility that empagliflozin may modulate cardiac autonomic function in patients with type 2 diabetes (T2D).</p><p><strong>Methods and results: </strong>The EMPYREAN study was a prospective randomized open-label assessor-blinded multicenter investigation of patients with T2D without prior antidiabetic therapy with sodium-glucose cotransporter 2 or dipeptidyl peptidase 4 inhibitors. Electrocardiographic monitoring was performed at study onset and after 12 and 24 weeks of treatment. Heart rate variability was analyzed using the MemCalc method. The primary endpoint was the change in the low frequency (LF; 0.04-0.15 Hz)/high frequency (HF; 0.15-0.4 Hz) ratio from baseline to 24 weeks. In all, 113 patients were randomized. The median age in the empagliflozin and sitagliptin groups was 60 and 63 years, respectively. There were no significant differences in serial changes in the LF/HF ratio (0.52, 95% confidence interval [CI] -0.15 to 1.19, P=0.126) or HF (16.13, 95% CI -11.58 to 43.84, P=0.251) between the 2 groups. In time domain analysis, serial changes in root mean square successive difference (1.90, 95% CI -0.56 to 4.38, P=0.12) and percent of difference between adjacent normal RR intervals >50 ms (1.04, 95% CI -0.32 to 2.41, P=0.13) were not significantly different.</p><p><strong>Conclusions: </strong>The effects of empagliflozin and sitagliptin on autonomic nerve activity did not differ significantly in patients with T2D.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617745","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":"Impact of Ultrathin Strut Biodegradable Polymer Sirolimus-Eluting Stents in Percutaneous Coronary Intervention for Hemodialysis Patients.","authors":"Narumi Taninobu, Shunsuke Kubo, Satoki Oka, Naoki Nishiura, Kenta Sasaki, Shunsuke Matsushita, Kazunori Mushiake, Yuki Shima, Akihiro Ikuta, Kohei Osakada, Yuichi Sawayama, Takeshi Tada, Yasushi Fuku, Hiroyuki Tanaka, Kazusige Kadota","doi":"10.1253/circj.CJ-24-0589","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0589","url":null,"abstract":"<p><strong>Background: </strong>Hemodialysis (HD) is associated with adverse cardiovascular events after percutaneous coronary intervention (PCI). Although the ultrathin strut biodegradable polymer sirolimus-eluting stent (ultrathin strut BP-SES) has had better results in patients undergoing PCI compared with other drug-eluting stents (DES), its usefulness in HD patients is unknown.</p><p><strong>Methods and results: </strong>This study involved 286 lesions in 162 HD patients who underwent PCI with a DES between January 2018 and June 2022. The incidence of clinically driven target lesion revascularization (TLR), target vessel failure (TVF: cardiac death, target vessel MI and clinically driven target vessel revascularization [TVR]) was assessed. During a median 636 days, clinically driven TLR occurred in 32 lesions. Clinically driven TLR at 2 years was significantly lower in the ultrathin strut BP-SES group than in the other DES group (2.9% vs. 17.3%, log-rank P=0.028). TVF occurred in 43 patients. The cumulative incidence of TVF was not different between two groups; however, clinically driven TVR was significantly lower in patients treated with the ultrathin strut BP-SES than with other DES (4.5% vs. 25.7%, log-rank P=0.027). In the quantitative coronary angiography analysis, late lumen loss at follow-up was significantly smaller in the ultrathin strut BP-SES group (0.13±0.40 vs. 0.67±1.02 mm, P<0.001).</p><p><strong>Conclusions: </strong>In patients on HD undergoing PCI, the incidence of clinically driven TLR was significantly lower in ultrathin strut BP-SES compared to other DES.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568739","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":"Accuracy of the 0/1-Hour Algorithm for Diagnosing Myocardial Infarction in Patients With Atrial Fibrillation.","authors":"Yuhei Kojima, Kenji Inoue, Masayuki Shiozaki, Shun Sasaki, Chien-Chang Lee, Shuo-Ju Chiang, Satoru Suwa, Tohru Minamino","doi":"10.1253/circj.CJ-24-0811","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0811","url":null,"abstract":"<p><strong>Background: </strong>Patients with atrial fibrillation (AF) often present with symptoms similar to acute coronary syndrome (ACS), including chest pain and elevated levels of high-sensitivity cardiac troponin (hs-cTn). The 0/1-hour algorithm using hs-cTn is a rapid diagnostic tool endorsed by the European Society of Cardiology to rule out myocardial infarction (MI). However, because its effectiveness in patients with AF remains unclear, in this study we assessed the diagnostic accuracy of the 0/1-hour algorithm in patients with and without AF presenting with chest pain in the emergency department.</p><p><strong>Methods and results: </strong>We conducted a secondary analysis of the DROP-ACS cohort, including 1,333 patients from Japan and Taiwan, with AF in 10.3% of cases. We examined the algorithm's negative predictive value (NPV), sensitivity, positive predictive value (PPV), and specificity for ruling MI in or out. Patients with AF were more frequently placed in the observe group (54% vs. 34.9%, P<0.05) and less often in the rule-out group (24.1% vs. 44.6%, P<0.05). The NPV and sensitivity for ruling out MI were 100%, while the PPV and specificity were lower in patients with AF (60% and 89.7%, respectively).</p><p><strong>Conclusions: </strong>The 0/1-hour algorithm effectively ruled out MI in patients with AF, with high safety and accuracy. However, patients with AF are more likely to be stratified into the observe group, requiring further examination for final diagnosis.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538029","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":"Rate-Dependent Left Bundle Branch Block in Transthyretin Amyloid Cardiomyopathy.","authors":"Kenta Uno, Naoki Fujimoto, Tetsuji Kitano, Keishi Moriwaki, Itaru Goto, Kaoru Dohi","doi":"10.1253/circj.CJ-24-0914","DOIUrl":"10.1253/circj.CJ-24-0914","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"393"},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025621","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":"¹²³I-β-Methyl Iodophenyl Pentadecanoic Acid and ²⁰¹Thallium Dual Myocardial Single-Photon Emission Computed Tomography (BMIPP/Tl SPECT) Detects Coronary Microvascular Dysfunction in a Patient With Antiphospholipid Syndrome Nephropathy.","authors":"Hiroaki Kawano, Mineaki Kitamura, Kumiko Muta, Tomoya Nishino, Takashi Kudo","doi":"10.1253/circj.CJ-24-0806","DOIUrl":"10.1253/circj.CJ-24-0806","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"392"},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958325","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":"Serial Assessment of Optical Coherence Tomography for Regression of Infectious Coronary Artery Aneurysm.","authors":"Shingo Sato, Aritomo Katsura, Jiro Ando, Takayuki Warisawa","doi":"10.1253/circj.CJ-24-0606","DOIUrl":"10.1253/circj.CJ-24-0606","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"391"},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980571","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":"Clinical Outcomes of Percutaneous Coronary Intervention Using Drug-Coated Balloons for De Novo Coronary Lesions With Eruptive Calcified Nodules as Detected by Optical Coherence Tomography.","authors":"Kento Fukui, Masahiro Koide, Kazuaki Takamatsu, Hikaru Sugimoto, Yuki Takeda, Satoshi Akabame, Tomotsugu Seki, Kan Zen, Satoaki Matoba","doi":"10.1253/circj.CJ-24-0588","DOIUrl":"10.1253/circj.CJ-24-0588","url":null,"abstract":"<p><strong>Background: </strong>The clinical outcomes of percutaneous coronary intervention (PCI) using drug-coated balloons (DCB) for de novo coronary artery lesions with eruptive calcified nodules remain unclear.</p><p><strong>Methods and results: </strong>This retrospective study analyzed the long-term outcomes of 308 consecutive patients (389 lesions) treated with PCI using DCB under optical coherence tomography guidance for de novo coronary artery lesions between September 2018 and November 2020. Patients were classified into 2 groups: those with an eruptive calcified nodule in the culprit lesion (CN group) and those without (non-CN group). The primary endpoint was major adverse cardiovascular events (MACE), including clinically driven target lesion revascularization (TLR), myocardial infarction (MI), and cardiac death. The median follow-up period was 2.6 years (interquartile range 1.9-3.4 years). The CN group had significantly higher rates of MACE (hazard ratio [HR] 9.2; 95% confidence interval [CI] 4.1-20.2; P<0.0001), TLR (HR 5.0; 95% CI 1.7-15.1; P<0.01), MI (HR 30.5; 95% CI 5.0-184.8; P<0.001), and cardiac death (HR 25.1; 95% CI 8.7-72.6; P<0.0001) than the non-CN group. Results were similar even after adjusting for potential confounding factors using propensity score matching.</p><p><strong>Conclusions: </strong>This study demonstrated that patients with eruptive calcified nodules who underwent PCI with DCB for de novo coronary artery lesions had worse long-term clinical outcomes than patients without such nodules.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"303-311"},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025582","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}