Circulation Journal最新文献_第2页

Sex Differences in Clinical Outcomes After Transcatheter Aortic Valve Implantation　- Insights From a Nationwide Japanese Registry. 经导管主动脉瓣植入术后临床结果的性别差异——来自日本全国登记的见解。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-08-27 DOI: 10.1253/circj.CJ-26-0492

Kentaro Mitsui, Kensuke Takagi, Yu Kataoka, Yoko Sumita, Koshiro Kanaoka, Yoshihiro Miyamoto, Yuki Irie, Atsushi Okada, Hideaki Kanzaki, Satsuki Fukushima, Kota Murai, Kenichiro Sawada, Hideo Matama, Takamasa Iwai, Satoshi Honda, Masashi Fujino, Kazuhiro Nakao, Shuichi Yoneda, Yasuhide Asaumi, Kenichi Tsujita, Kazuhiro Yamamoto, Teruo Noguchi

{"title":"Sex Differences in Clinical Outcomes After Transcatheter Aortic Valve Implantation　- Insights From a Nationwide Japanese Registry.","authors":"Kentaro Mitsui, Kensuke Takagi, Yu Kataoka, Yoko Sumita, Koshiro Kanaoka, Yoshihiro Miyamoto, Yuki Irie, Atsushi Okada, Hideaki Kanzaki, Satsuki Fukushima, Kota Murai, Kenichiro Sawada, Hideo Matama, Takamasa Iwai, Satoshi Honda, Masashi Fujino, Kazuhiro Nakao, Shuichi Yoneda, Yasuhide Asaumi, Kenichi Tsujita, Kazuhiro Yamamoto, Teruo Noguchi","doi":"10.1253/circj.CJ-26-0492","DOIUrl":"https://doi.org/10.1253/circj.CJ-26-0492","url":null,"abstract":"Background: Sex differences in outcomes after transcatheter aortic valve implantation (TAVI) for aortic stenosis in Japan have not been fully investigated.Methods and results: Using a nationwide registry, we evaluated sex differences in post-TAVI outcomes. In all, 36,353 patients (23,978 women, 12,375 men) were included. Women were older (84.9 vs. 83.5 years; P<0.001), had a smaller body surface area (BSA; 1.38 vs. 1.60 m2; P<0.001), and a lower prevalence of comorbidities than men. In-hospital mortality was comparable between women and men (1.2% vs. 1.3%, respectively; P=0.367). Women had higher rates of major red cell concentrate (RCC) transfusion (10.1% vs. 8.7%; P<0.001) and permanent pacemaker implantation (PPI; 7.1% vs. 5.9%; P<0.001). In multivariable analysis, BSA was inversely associated with in-hospital mortality (adjusted odds ratio [aOR] 0.84 per 0.1-m2increase; 95% confidence interval [CI] 0.77-0.91; P<0.001). Female sex was independently associated with lower risks of in-hospital mortality (aOR 0.60; 95% CI 0.45-0.81) and major RCC transfusion (aOR 0.79; 95% CI 0.71-0.89), but a higher risk of PPI (aOR 1.15; 95% CI 1.02-1.30).Conclusions: In a Japanese TAVI registry, crude mortality was comparable between the sexes, but women had higher major RCC transfusion and PPI rates. After adjusting for BSA and available measured covariates, female sex was associated with lower in-hospital mortality. Combined sex and BSA assessment appears important for predicting post-TAVI outcomes.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833325","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

Long-Term Effectiveness and Safety of Direct Oral Anticoagulants in Japanese Patients With Venous Thromboembolism　- Extended Follow-up Results From the KUROSIO Study. 日本静脉血栓栓塞患者直接口服抗凝剂的长期有效性和安全性——来自KUROSIO研究的延长随访结果

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-08-27 DOI: 10.1253/circj.CJ-26-0316

Michihisa Umetsu, Kenichi Tsujita, Masato Nakamura, Atsuyuki Watanabe, Mitsuru Yuzaki, Masataka Sata, Kazuhiko Yumoto, Wataru Shimizu, Koji Maemura, Yoshito Ogihara, Yuki Nishimura, Toru Ogura, Takeshi Yamamoto, Hirono Satokawa, Toru Obayashi, Satoshi Tamaru, Norikazu Yamada, Mashio Nakamura

{"title":"Long-Term Effectiveness and Safety of Direct Oral Anticoagulants in Japanese Patients With Venous Thromboembolism　- Extended Follow-up Results From the KUROSIO Study.","authors":"Michihisa Umetsu, Kenichi Tsujita, Masato Nakamura, Atsuyuki Watanabe, Mitsuru Yuzaki, Masataka Sata, Kazuhiko Yumoto, Wataru Shimizu, Koji Maemura, Yoshito Ogihara, Yuki Nishimura, Toru Ogura, Takeshi Yamamoto, Hirono Satokawa, Toru Obayashi, Satoshi Tamaru, Norikazu Yamada, Mashio Nakamura","doi":"10.1253/circj.CJ-26-0316","DOIUrl":"https://doi.org/10.1253/circj.CJ-26-0316","url":null,"abstract":"Background: The KUROSIO study (UMIN000023747) previously demonstrated the efficacy and safety of direct oral anticoagulants (DOACs) over 52 weeks in patients with acute venous thromboembolism (VTE). However, the long-term outcomes of anticoagulation therapy in real-world practice remain unclear.Methods and results: We conducted a prespecified analysis with a 156-week clinical observation period. The primary efficacy outcome was symptomatic recurrent VTE, and the primary safety outcome was major bleeding at 156 weeks. Between September 2016 and November 2018, the study enrolled 1,017 patients, of whom 993 were eligible for analysis. The cumulative incidence of recurrent VTE and major bleeding at 52 weeks was 3.2% and 2.2%, respectively. The mean duration of DOAC therapy was 458.0 days. Symptomatic recurrent VTE occurred in 50 (5.0%) patients, including pulmonary embolism in 46 (4.6%) and deep vein thrombosis in 4 (0.4%). Major bleeding occurred in 26 (2.6%) patients. Multivariable analysis identified chemotherapy (hazard ratio [HR] 3.580) as a factor associated with recurrent VTE. For major bleeding, multivariable analysis identified lower baseline hemoglobin (HR 0.657), history of cerebral infarction (HR 7.250), and concomitant use of non-steroidal anti-inflammatory drugs other than aspirin at enrollment (HR 7.481) as significant risk factors.Conclusions: DOAC therapy showed sustained effectiveness and acceptable safety over 156 weeks in Japanese patients with VTE, supporting individualized decisions regarding treatment duration and bleeding risk.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834515","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

Symptomatic Pulmonary Regurgitation Without Right Ventricular Enlargement Accompanied by Biventricular Diastolic Dysfunction in Repaired Tetralogy of Fallot and Related Diseases. 法洛四联症及相关疾病修复后无右心室扩大伴双室舒张功能障碍的症状性肺反流。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-08-25 Epub Date: 2026-01-20 DOI: 10.1253/circj.CJ-25-0786

Sayuri Yamabe, Kiyomi Kayama, Yoshiro Tsuruta, Yu Kawada, Tatsuya Mizoguchi, Masashi Yokoi, Kento Mori, Tsuyoshi Ito, Kyoko Matsui, Shuichi Kitada, Toshihiko Goto, Masahiro Yasuda, Hitomi Kimura, Satoshi Koyama, Tsutomu Shinohara, Keiichi Itatani, Yoshihiro Seo

引用次数: 0

Dynamic Changes and Prognostic Impact of Ischemic Mitral Regurgitation in Recurrent Myocardial Infarction. 复发性心肌梗死缺血性二尖瓣返流的动态变化及其对预后的影响。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-08-25 Epub Date: 2026-07-23 DOI: 10.1253/circj.CJ-26-0430

Chiharu Nishino, Shun Nishino, Akihiro Hayashida, Michinari Hieda, Shutaro Futami, Kensaku Nishihira, Keiichi Ashikaga, Nehiro Kuriyama, Yoshisato Shibata, Kenichi Tsujita

{"title":"Dynamic Changes and Prognostic Impact of Ischemic Mitral Regurgitation in Recurrent Myocardial Infarction.","authors":"Chiharu Nishino, Shun Nishino, Akihiro Hayashida, Michinari Hieda, Shutaro Futami, Kensaku Nishihira, Keiichi Ashikaga, Nehiro Kuriyama, Yoshisato Shibata, Kenichi Tsujita","doi":"10.1253/circj.CJ-26-0430","DOIUrl":"10.1253/circj.CJ-26-0430","url":null,"abstract":"Background: The prognostic impact of ischemic mitral regurgitation (IMR) in recurrent myocardial infarction (MI) remains poorly defined. This study evaluated dynamic changes in IMR during recurrent MI and determined prognostic implications.Methods and results: We retrospectively reviewed 4,091 patients who underwent primary percutaneous coronary intervention for acute MI between May 2008 and July 2022. Of these patients, 88 experienced a second MI and underwent transthoracic echocardiography at 3 time points: before recurrent MI, at onset, and at discharge. IMR severity was assessed using mean vena contracta width. Logistic regression was used to determine predictors of persistent IMR, and Cox analysis was used to evaluate 5-year adverse outcomes (a composite of all-cause death, heart failure hospitalization, and third MI). IMR worsened at the onset of recurrent MI and remained elevated at discharge (P<0.001). Older age, lower left ventricular ejection fraction (LVEF), and greater IMR severity at onset independently predicted persistent IMR. In multivariable Cox analysis, residual IMR (per 1-mm increase: hazard ratio [HR] 1.22; 95% confidence interval [CI] 1.08-1.38) and reduced LVEF (per 1% decrease: HR 0.95; 95% CI 0.92-0.98) were independently associated with a higher risk of 5-year adverse events.Conclusions: IMR changes dynamically during recurrent MI and often persists despite acute treatment. Residual IMR and reduced LVEF predicted long-term adverse outcomes, highlighting the importance of residual IMR assessment for risk stratification.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1233-1243"},"PeriodicalIF":5.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563721","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

Interpreting Low Pressure Pullback Gradient in Non-Culprit Lesions With Quantitative Flow Ratio ≥0.80　- Reply. 定量流量比≥0.80的非罪魁祸首病变低压回拉梯度的解释-回复。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-08-25 Epub Date: 2026-08-06 DOI: 10.1253/circj.CJ-26-0652

Sho Nakao, Takayuki Ishihara, Toshiaki Mano

引用次数: 0

Diastolic Musical Murmur From Late Commissural Tear of an Evolut R Valve. 渐开式R瓣晚期联合撕裂引起的舒张期音乐性杂音。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-08-25 Epub Date: 2026-07-25 DOI: 10.1253/circj.CJ-26-0487

Tomohiko Taniguchi, Toshiaki Toyota, Jiro Esaki, Yutaka Furukawa

引用次数: 0

Evaluation of Perioperative Cardiovascular Event Risk in Gastrointestinal Surgery　- Predictive Modeling and Risk Stratification Using Machine Learning. 胃肠手术围手术期心血管事件风险评估-机器学习预测模型和风险分层。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-08-25 Epub Date: 2025-04-24 DOI: 10.1253/circj.CJ-25-0032

Hiromasa Ito, Tomohisa Seki, Yoshimasa Kawazoe, Toru Takiguchi, Yu Akagi, Kazumi Kubota, Kana Miyake, Masafumi Okada, Kazuhiko Ohe

{"title":"Evaluation of Perioperative Cardiovascular Event Risk in Gastrointestinal Surgery　- Predictive Modeling and Risk Stratification Using Machine Learning.","authors":"Hiromasa Ito, Tomohisa Seki, Yoshimasa Kawazoe, Toru Takiguchi, Yu Akagi, Kazumi Kubota, Kana Miyake, Masafumi Okada, Kazuhiko Ohe","doi":"10.1253/circj.CJ-25-0032","DOIUrl":"10.1253/circj.CJ-25-0032","url":null,"abstract":"Background: Preoperative risk assessment is very important to ensure surgical safety and predict postoperative complications. However, no large-scale studies have evaluated the risk of perioperative cardiovascular events in Japan. This study evaluated perioperative cardiovascular events using real-world data. In addition, the applicability of machine learning to risk stratification was examined to develop a predictive model for perioperative cardiovascular events.Methods and results: This was an observational cohort study using the Japan Medical Data Center database, which includes claim and health examination data in Japan, between January 2005 and April 2021. In all, 133,634 gastrointestinal surgeries were included in the analysis. The primary outcome was 30-day risk of major adverse cardiovascular events (MACE). The 30-day MACE incidence rate following surgery was 3.8%. Machine learning was used to perform a binary classification task to predict MACE occurrence within 30 days after surgery. A clustering algorithm was developed based on the Shapley additive explanation values obtained from training data, and generalizability was evaluated using test data. Of the variables, age, history of ischemic heart disease or heart failure, history of stroke, diabetes, hypertension, atrial fibrillation, cases of malignancy, and pancreatic biliary surgery were identified as factors associated with MACE occurrence.Conclusions: A machine learning model built from basic clinical information, comorbidities, and surgical information demonstrated the capacity to stratify MACE risk in patients undergoing gastrointestinal surgery.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1280-1289"},"PeriodicalIF":5.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065212","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

Clinical Relevance of Atriogenic Tethering in Atrial Functional Mitral Regurgitation. 房源性栓系在心房功能性二尖瓣反流中的临床意义。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-08-25 Epub Date: 2025-09-19 DOI: 10.1253/circj.CJ-25-0651

Kenya Kusunose

引用次数: 0

Aortic Regurgitation Jet Increases Left Ventricular Energy Loss Associated With the Progression of Cardiac Failure　- A Vector Flow Mapping Analysis Study. 主动脉反流射流增加左心室能量损失与心力衰竭进展相关——一项矢量血流图分析研究。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-08-25 Epub Date: 2025-08-10 DOI: 10.1253/circj.CJ-24-0965

Shohei Yoshida, Koichi Toda, Yasushi Yoshikawa, Hiroki Hata, Daisuke Yoshioka, Satoshi Kainuma, Takuji Kawamura, Ai Kawamura, Koichi Inoue, Yumi Kakizawa, Scott DeRoo, Christopher R Burke, Satoshi Nakatani, Kazuo Shimamura, Yoshiki Sawa, Shigeru Miyagawa

{"title":"Aortic Regurgitation Jet Increases Left Ventricular Energy Loss Associated With the Progression of Cardiac Failure　- A Vector Flow Mapping Analysis Study.","authors":"Shohei Yoshida, Koichi Toda, Yasushi Yoshikawa, Hiroki Hata, Daisuke Yoshioka, Satoshi Kainuma, Takuji Kawamura, Ai Kawamura, Koichi Inoue, Yumi Kakizawa, Scott DeRoo, Christopher R Burke, Satoshi Nakatani, Kazuo Shimamura, Yoshiki Sawa, Shigeru Miyagawa","doi":"10.1253/circj.CJ-24-0965","DOIUrl":"10.1253/circj.CJ-24-0965","url":null,"abstract":"Background: Aortic valve regurgitation (AR) impairs cardiac function, but the underlying mechanisms remain unclear. Vector flow mapping (VFM) enables evaluation of blood flow patterns and energy loss in the left ventricle (LV). This study investigated the effect of AR on LV blood flow patterns, energy loss, and heart failure progression using VFM.Methods and results: Forty patients with severe AR undergoing aortic valve replacement (AVR) between January 2016 and March 2018 were included. Echocardiogram-based VFM in apical long-axis and 4-chamber views was performed before and after AVR, with results compared to a control group without valvular diseases (n=21). Preoperative LV energy loss due to an AR jet was significantly higher in patients with AR (median 8.7 J; interquartile range [IQR] 5.7-13.3 J) than in controls (1.7 J; IQR 0.7-2.6 J; P<0.001), and was positively correlated with preoperative serum B-type natriuretic peptide (BNP) concentrations (P=0.029). LV energy loss was not associated with LV systolic function or regurgitant volume, but was significantly affected by AR jet direction. Postoperatively, after AVR, LV energy loss (median 2.0 J; IQR 1.5-2.7 J) decreased to the same level as in the control group.Conclusions: The regurgitant jet in severe AR increases LV energy loss, which is positively correlated with serum BNP concentrations, indicating that the AR jet contributes to the progression of heart failure through LV energy loss.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1244-1253"},"PeriodicalIF":5.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823160","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

Beyond Volume Criteria　- Individualized Approach to Pulmonary Regurgitation in Tetralogy of Fallot and Related Diseases. 超越容积标准——法洛四联症及相关疾病中肺反流的个体化治疗方法。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-08-25 Epub Date: 2026-02-05 DOI: 10.1253/circj.CJ-25-1157

Kenichiro Yamamura, Ayako Ishikita

引用次数: 0