Circulation Journal最新文献_第2页

Surgical Repair of Right Ventricular Free Wall Blow-Out Rupture. 右心室游离壁爆破破裂的外科修复。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-30 DOI: 10.1253/circj.CJ-26-0741

Masayuki Nishiyama, Takayuki Okada, Takashi Nishimura, Kei Tanaka, Takahiko Naruko, Tadaaki Koyama

引用次数: 0

Serial 4-Dimensional Flow Cardiac Magnetic Resonance Imaging Visualizes Incremental Hemodynamic Improvement Following Alcohol Septal Ablation and Subsequent Mavacamten Therapy. 连续4维血流心脏磁共振成像显示酒精室间隔消融和随后的马伐卡坦治疗后血流动力学的改善。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-30 DOI: 10.1253/circj.CJ-26-0757

Keitaro Akita, Kenichiro Suwa, Yuichiro Maekawa

引用次数: 0

When Earlier Is Better But Still Not Cost-Effective　- Reframing the Value of Tafamidis in Transthyretin Amyloid Cardiomyopathy. 越早越好，但仍不划算——重新定义他法非地在转甲状腺素淀粉样心肌病中的价值。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-30 DOI: 10.1253/circj.CJ-26-0898

Takuya Kishi

引用次数: 0

Stage-Specific Cost-Effectiveness of Early vs. Delayed Tafamidis for Transthyretin Amyloid Cardiomyopathy in Japan. 在日本，早期与延迟Tafamidis治疗转甲状腺素淀粉样心肌病的阶段特异性成本-效果

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-29 DOI: 10.1253/circj.CJ-26-0576

Yasufumi Nagata, Yosuke Nabeshima, Tetsuji Kitano, Masaaki Takeuchi, Masaharu Kataoka

{"title":"Stage-Specific Cost-Effectiveness of Early vs. Delayed Tafamidis for Transthyretin Amyloid Cardiomyopathy in Japan.","authors":"Yasufumi Nagata, Yosuke Nabeshima, Tetsuji Kitano, Masaaki Takeuchi, Masaharu Kataoka","doi":"10.1253/circj.CJ-26-0576","DOIUrl":"https://doi.org/10.1253/circj.CJ-26-0576","url":null,"abstract":"Background: Tafamidis improves survival in patients with transthyretin amyloid cardiomyopathy (ATTR-CM); however, its cost raises concerns regarding healthcare sustainability. We evaluated the stage-specific cost-effectiveness of tafamidis in Japan.Methods and results: Individual patient-level data were reconstructed from published Kaplan-Meier curves from the ATTR-ACT long-term extension study. Time-dependent survival benefit between early (continuous tafamidis) and delayed (placebo-to-tafamidis) tafamidis initiation was quantified using restricted mean survival time (RMST). Stage-specific incremental cost-effectiveness ratios (ICERs) were estimated according to National Amyloidosis Centre (NAC) stage. Drug costs reflected the official Japanese reimbursement price, and quality-adjusted life years (QALYs) were derived from RMST gains. The primary endpoint was cardiovascular mortality. At maximum follow-up, RMST gains were 15.7, 13.1, and 1.2 months in NAC stage I, II, and III, respectively ICERs declined over time but remained above commonly accepted Japanese willingness-to-pay thresholds (5,000,000-15,000,000 yen/QALY). The lowest ICER was 47,000,000 yen/QALY in NAC stage I at 90 months. Sensitivity analyses showed that results were robust across utility assumptions, whereas drug cost was the principal determinant of cost-effectiveness.Conclusions: The survival benefit and economic value of tafamidis varied by disease stage. Earlier-stage patients derived the greatest benefit and economic value; however, ICERs remained above Japanese willingness-to-pay thresholds across all NAC stages. Earlier diagnosis may maximize clinical benefit, but substantial price reduction is likely required for sustainable healthcare in ATTR-CM.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117998","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

Low Body Weight and Long-Term Outcomes in Cancer-Associated Venous Thromboembolism　- From the COMMAND VTE Registry-2. 低体重和癌症相关静脉血栓栓塞的长期结局-来自命令静脉血栓栓塞登记-2

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-25 Epub Date: 2026-08-20 DOI: 10.1253/circj.CJ-26-0325

Soichiro Kobayashi, Yoshito Ogihara, Yugo Yamashita, Takeshi Morimoto, Ryuki Chatani, Kazuhisa Kaneda, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kitae Kim, Masayuki Shiba, Toru Takase, Shuhei Tsuji, Maki Oi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Takeshi Inoue, Shunsuke Usami, Po-Min Chen, Kiyonori Togi, Norimichi Koitabashi, Seiichi Hiramori, Kosuke Doi, Hiroshi Mabuchi, Yoshiaki Tsuyuki, Koichiro Murata, Kensuke Takabayashi, Hisato Nakai, Daisuke Sueta, Wataru Shioyama, Tomohiro Dohke, Toru Sato, Ryusuke Nishikawa, Takeshi Kimura, Kaoru Dohi

{"title":"Low Body Weight and Long-Term Outcomes in Cancer-Associated Venous Thromboembolism　- From the COMMAND VTE Registry-2.","authors":"Soichiro Kobayashi, Yoshito Ogihara, Yugo Yamashita, Takeshi Morimoto, Ryuki Chatani, Kazuhisa Kaneda, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kitae Kim, Masayuki Shiba, Toru Takase, Shuhei Tsuji, Maki Oi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Takeshi Inoue, Shunsuke Usami, Po-Min Chen, Kiyonori Togi, Norimichi Koitabashi, Seiichi Hiramori, Kosuke Doi, Hiroshi Mabuchi, Yoshiaki Tsuyuki, Koichiro Murata, Kensuke Takabayashi, Hisato Nakai, Daisuke Sueta, Wataru Shioyama, Tomohiro Dohke, Toru Sato, Ryusuke Nishikawa, Takeshi Kimura, Kaoru Dohi","doi":"10.1253/circj.CJ-26-0325","DOIUrl":"10.1253/circj.CJ-26-0325","url":null,"abstract":"Background: Low body weight (BW) is reportedly associated with an increased risk of bleeding and mortality in venous thromboembolism (VTE). However, there are limited data on the impact of low BW on clinical outcomes among patients with cancer-associated VTE in the direct oral anticoagulants (DOACs) era.Methods and results: We analyzed 1,484 patients with symptomatic VTE and active cancer from the COMMAND VTE Registry-2, and divided the cohort into low (≤60 kg) and non-low (>60 kg) BW groups (n=969 and 515, respectively). The cumulative 3-year incidence of major bleeding was significantly higher in the low than non-low BW group (13.1% vs. 10.2%; Gray's P=0.04). However, after adjustment, the risk of major bleeding in the low BW was no longer significantly different to that in the non-low BW group (hazard ratio [HR] 1.36; 95% confidence interval [CI] 0.96-1.92). The cumulative 3-year incidence of recurrent VTE did not differ significantly between the low and non-low groups (5.2% vs. 5.4%, respectively; Gray's P=0.46; adjusted HR 0.71; 95% CI 0.42-1.18). The cumulative 3-year incidence of all-cause death was significantly higher in the low than non-low BW group (65.0% vs. 50.8%; log-rank P<0.001; adjusted HR 1.47; 95% CI 1.25-1.73).Conclusions: Low BW in cancer-associated VTE was not associated with major bleeding or recurrent VTE, but was associated with all-cause death, possibly reflecting cancer-related prognostic factors.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1336-1347"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800545","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

Prognostic Value of Right Ventricular Septal Longitudinal Strain in Intermediate-Risk Pulmonary Embolism. 右室间隔纵向应变对中危性肺栓塞的预后价值。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-25 Epub Date: 2026-05-14 DOI: 10.1253/circj.CJ-25-1133

Ayumi Eguchi, Shunsuke Eguchi, Yoshiyuki Orihara, Michael Pfeiffer, Brandon Peterson, Mohammed Ruzieh, John Boehmer, John Gorcsan Iii, Ryan Wilson

{"title":"Prognostic Value of Right Ventricular Septal Longitudinal Strain in Intermediate-Risk Pulmonary Embolism.","authors":"Ayumi Eguchi, Shunsuke Eguchi, Yoshiyuki Orihara, Michael Pfeiffer, Brandon Peterson, Mohammed Ruzieh, John Boehmer, John Gorcsan Iii, Ryan Wilson","doi":"10.1253/circj.CJ-25-1133","DOIUrl":"10.1253/circj.CJ-25-1133","url":null,"abstract":"Background: The interventricular septum contributes 30-60% of right ventricular (RV) output. However, few studies have assessed the prognostic value of RV septal strain in pulmonary embolism (PE). We hypothesized that RV septal strain would predict 30-day mortality in patients with intermediate-risk PE.Methods and results: This retrospective cohort study analyzed consecutive patients with intermediate-risk PE admitted to the Penn State Health Milton S. Hershey Medical Center between 2010 and 2018. The primary outcome was 30-day all-cause mortality. RV septal strain was measured within the RV endocardium and was defined as the mean of basal, mid, and apical septal longitudinal strain. Among 251 patients, 31 (12.4%) died within 30 days of PE diagnosis. RV strain analysis was feasible in 230 (91.6%) patients. RV septal strain was significantly lower in those who died and was independently associated with 30-day mortality (P<0.001). Receiver operating characteristic curve analysis indicated 14.4% as the optimal RV septal strain cut-off value (area under the curve 0.816). Kaplan-Meier curves demonstrated that 30-day mortality risk was higher among patients with low (≤14.4%) than high (>14.4%) RV septal strain (hazard ratio 9.29; P<0.001).Conclusions: RV septal strain is a feasible and reproducible parameter with strong prognostic value in patients with intermediate-risk PE. These findings highlight the central role of the interventricular septum in RV function and risk stratification.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1358-1367"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935096","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

Serial N-Terminal pro B-Type Natriuretic Peptide in the Community　- Dynamic Risk Signal or Incremental Predictor? 社区序列n端前b型利钠肽-动态风险信号还是增量预测因子？

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-25 Epub Date: 2026-09-09 DOI: 10.1253/circj.CJ-26-0682

Kazutaka Nogi

引用次数: 0

A High Level of Calculated Small Dense Low-Density Lipoprotein Cholesterol Is an Independent Risk Factor for the Progression of Renal Impairment. 高水平的计算小密度低密度脂蛋白胆固醇是肾脏损害进展的独立危险因素。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-25 Epub Date: 2026-06-26 DOI: 10.1253/circj.CJ-26-0114

Hiroki Aida, Marenao Tanaka, Tatsuya Sato, Koki Abe, Keitaro Nishizawa, Wataru Kawaharata, Rie Matsumori, Itaru Hosaka, Yukinori Akiyama, Kei Nakata, Hidemichi Kouzu, Naoya Yama, Nagisa Hanawa, Masato Furuhashi

{"title":"A High Level of Calculated Small Dense Low-Density Lipoprotein Cholesterol Is an Independent Risk Factor for the Progression of Renal Impairment.","authors":"Hiroki Aida, Marenao Tanaka, Tatsuya Sato, Koki Abe, Keitaro Nishizawa, Wataru Kawaharata, Rie Matsumori, Itaru Hosaka, Yukinori Akiyama, Kei Nakata, Hidemichi Kouzu, Naoya Yama, Nagisa Hanawa, Masato Furuhashi","doi":"10.1253/circj.CJ-26-0114","DOIUrl":"10.1253/circj.CJ-26-0114","url":null,"abstract":"Background: Beyond low-density lipoprotein cholesterol (LDL-C), small dense LDL-C (sdLDL-C) is a residual risk factor for atherosclerotic cardiovascular disease. However, whether sdLDL-C levels can predict the development of chronic kidney disease remains unclear.Methods and results: We investigated the association between the sdLDL-C level calculated using Sampson's equation and the progression of renal impairment in 16,814 Japanese individuals (10,806 men, 6,008 women; mean age: 47 years) who underwent annual health checkups. Participants were divided into 4 groups according to high (H) or low (L) sdLDL-C and LDL-C levels. Over a 10-year follow-up period, 2,533 participants progressed renal impairment, defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2or positive for urine protein. Cox proportional hazards model with a restricted cubic spline after adjustment for confounders showed a gradual increase in the hazard ratio (HR) for renal impairment with high levels of sdLDL-C. Compared with the L-sdLDL-C/L-LDL-C group (reference) the adjusted HRs for renal impairment were significantly higher in the H-sdLDL-C/H-LDL-C and H-sdLDL-C/L-LDL-C groups (1.13 [95% confidence interval 1.03-1.25] and 1.15 [95% confidence interval 1.03-1.29], respectively). The addition of a high sdLDL-C level (≥35.7 mg/dL) to traditional risk factors significantly improved the discriminatory capacity for renal impairment.Conclusions: A high calculated sdLDL-C level was an independent predictor for the progression of renal impairment regardless of LDL-C level in a general Japanese population.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1435-1443"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346999","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

Characterizing Manifestations of Optical Coherence Tomography in Pulmonary Arterial Lesions. 光学相干断层扫描在肺动脉病变中的表现特征。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-25 Epub Date: 2026-06-11 DOI: 10.1253/circj.CJ-25-0717

Jielong Lin, Jiawei Long, Wenliang Guo, Xiaofeng Wu, Xinye Xia, Meiyan Chen, Dongda Zhou, Cheng Hong

{"title":"Characterizing Manifestations of Optical Coherence Tomography in Pulmonary Arterial Lesions.","authors":"Jielong Lin, Jiawei Long, Wenliang Guo, Xiaofeng Wu, Xinye Xia, Meiyan Chen, Dongda Zhou, Cheng Hong","doi":"10.1253/circj.CJ-25-0717","DOIUrl":"10.1253/circj.CJ-25-0717","url":null,"abstract":"Background: Effective imaging is lacking for intravascular lesions in pulmonary vascular diseases. Optical coherence tomography (OCT) offers micron-level resolution, enabling improved diagnosis and treatment guidance. This study aimed to evaluate pulmonary arterial lesions using OCT.Methods and results: This retrospective study reviewed consecutive patients with pulmonary arterial lesions undergoing OCT at The First Affiliated Hospital of Guangzhou Medical University between August 2022 and November 2024. Patients with chronic thromboembolic pulmonary disease, Takayasu arteritis, Behçet's disease, or fibrosing mediastinitis were included in the study. Arterial lesions assessed included fresh, subacute, and chronic thrombus, vascular dissection, and other OCT findings. Seventy-two patients (median age 57.5 years [interquartile range 48.0-66.0 years]; 39 [54.17%] males) were included in the study. The OCT features were as follows: fresh thrombus showed irregular regions with marked signal attenuation; subacute thrombus appeared as intraluminal clumps surrounding the catheter; chronic thrombus presented as multichambered mesh-like structures; Takayasu arteritis and Behçet's disease exhibited bead-like eccentric intimal thickening with vacuole-like changes; fibrosing mediastinitis showed an irregular lumen with high attenuation behind the wall; and vascular dissection presented as dark areas with occasional lumen communication and a streak-like longitudinal appearance.Conclusions: OCT yields high-resolution imaging for detailed assessment of pulmonary vascular diseases and holds promise for clinical application.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1463-1472"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935084","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

Systematic Review and Meta-Analysis for JCS 2026 Guideline on Management of Large-Vessel Vasculitis. JCS 2026大血管炎治疗指南的系统评价和meta分析。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-25 Epub Date: 2026-02-19 DOI: 10.1253/circj.CJ-25-1129

Tsuyoshi Shirai, Tsuneyasu Yoshida, Eri Sugano, Ryosuke Hiwa, Ryuhei Ishihara, Ryo Yanai, Nobuyuki Yajima, Takashi Kida, Norihiro Nishioka, Ryota Sakai, Takaya Handa, Manabu Honda, Jun Ishizaki, Keiichiro Kadoba, Yuji Kamiyama, Genki Kidoguchi, Takatoyo Kiko, Daisuke Kobayashi, Kazuhiro Kobayashi, Shun Nakagama, Yu Nakano, Hajime Sanada, Shin-Ya Tamechika, Jin Ueda, Kenji Nagasaka, Takahiko Sugihara, Naoto Tamura, Yoshikazu Nakaoka

{"title":"Systematic Review and Meta-Analysis for JCS 2026 Guideline on Management of Large-Vessel Vasculitis.","authors":"Tsuyoshi Shirai, Tsuneyasu Yoshida, Eri Sugano, Ryosuke Hiwa, Ryuhei Ishihara, Ryo Yanai, Nobuyuki Yajima, Takashi Kida, Norihiro Nishioka, Ryota Sakai, Takaya Handa, Manabu Honda, Jun Ishizaki, Keiichiro Kadoba, Yuji Kamiyama, Genki Kidoguchi, Takatoyo Kiko, Daisuke Kobayashi, Kazuhiro Kobayashi, Shun Nakagama, Yu Nakano, Hajime Sanada, Shin-Ya Tamechika, Jin Ueda, Kenji Nagasaka, Takahiko Sugihara, Naoto Tamura, Yoshikazu Nakaoka","doi":"10.1253/circj.CJ-25-1129","DOIUrl":"10.1253/circj.CJ-25-1129","url":null,"abstract":"Background: To provide evidence from randomized controlled trials (RCTs) for large-vessel vasculitis (LVV), including Takayasu arteritis (TAK) and giant cell arteritis (GCA), to inform the forthcoming 2026 Japanese Circulation Society (JCS) clinical practice guideline.Methods and results: We drafted 4 and 7 clinical questions for TAK and GCA, respectively. A systematic review (SR) of RCTs was conducted using PubMed, CENTRAL, EMBASE, and the Japan Medical Abstracts Society through March 2024. Assessed with the GRADE approach, the certainty of evidence was very low for the most critical outcomes, low for some outcomes, and moderate for only 1 outcome. Evidence for TAK was limited. Tocilizumab (TCZ) resulted in a numerically lower relapse rate vs. placebo (risk ratio (RR) 0.73, 95% confidence interval (CI) 0.39-1.37) and was similar to adalimumab. No clear difference between mycophenolate mofetil (MMF) and methotrexate (MTX), or between abatacept (ABA) and placebo was observed. In GCA, TCZ reduced relapse (RR 0.29, 95% CI 0.09-0.98) and increased remission (RR 3.56, 95% CI 2.29-5.54) over placebo at 52 weeks. Tumor necrosis factor inhibitor, ABA, and MTX showed no benefit in cranial GCA. Serious adverse events were comparable between treatment groups. Geographic variation and differences in entry criteria were noted.Conclusions: This SR was comprehensive synthesis of evidence from RCTs for LVV therapies to support the 2026 JCS guideline.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1326-1335"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203569","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