Circulation Journal最新文献_第3页

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

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

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 : 2026-09-25 Epub 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":"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":"1351-1357"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","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

Epidemiology of Cardiovascular Disease in Pregnancy in Japan　- Analysis of a Nationwide Perinatal Database 2014-2023. 日本妊娠期心血管疾病流行病学——2014-2023年全国围产期数据库分析

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-25 Epub Date: 2026-06-05 DOI: 10.1253/circj.CJ-26-0154

Masafumi Nii, Shoko Chishaki-Kawabata, Koshiro Kanaoka, Shinji Katsuragi, Chizuko Aoki-Kamiya

{"title":"Epidemiology of Cardiovascular Disease in Pregnancy in Japan　- Analysis of a Nationwide Perinatal Database 2014-2023.","authors":"Masafumi Nii, Shoko Chishaki-Kawabata, Koshiro Kanaoka, Shinji Katsuragi, Chizuko Aoki-Kamiya","doi":"10.1253/circj.CJ-26-0154","DOIUrl":"10.1253/circj.CJ-26-0154","url":null,"abstract":"Background: Cardiovascular disease (CVD) is an increasingly important contributor to maternal morbidity and mortality worldwide, but contemporary nationwide data in Japan remain limited.Methods and results: We conducted a retrospective cohort study using the Japan Society of Obstetrics and Gynecology Perinatal Database from 2014 to 2023. Among 2,189,852 registered pregnancies, 26,894 (1.23%) were complicated by maternal CVD. Pregnancies with CVD were compared with the low-risk population (pregnancies without any medical comorbidities; n=1,882,896). Pregnancies with CVD had lower parity and more frequently required cesarean delivery, general anesthesia, and labor analgesia than the low-risk population. Maternal cardiovascular complications, including hypertensive disorders of pregnancy, pulmonary embolism and pulmonary edema, occurred at higher rates among pregnancies with CVD. Maternal death was rare in both groups, but was more frequent in pregnancies with CVD than in the low-risk population (0.03% vs 0.01%, P<0.001). Neonatal outcomes were generally similar between groups.Conclusions: In this nationwide registry analysis, approximately 1% of pregnancies in Japan were complicated by maternal CVD. Women with CVD underwent more obstetric and anesthetic interventions and had a modestly higher risk of maternal morbidity and mortality. These findings underscore the importance of continued registry surveillance and may help inform risk-stratified perinatal management.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1381-1388"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200867","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

Impact of Glucose Fluctuations on the Human Epicardial Adipocyte-Derived Paracrine Secretome. 葡萄糖波动对人心外膜脂肪细胞衍生旁分泌组的影响。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-25 Epub Date: 2026-07-31 DOI: 10.1253/circj.CJ-26-0082

Masayuki Takano, Hidekazu Kondo, Taisuke Harada, Masaki Takahashi, Yumi Ishii, Hirochika Yamasaki, Takashi Shuto, Yasushi Teshima, Tomoyuki Wada, Kunio Yufu, Hidenori Sako, Hirofumi Anai, Shinji Miyamoto, Naohiko Takahashi

{"title":"Impact of Glucose Fluctuations on the Human Epicardial Adipocyte-Derived Paracrine Secretome.","authors":"Masayuki Takano, Hidekazu Kondo, Taisuke Harada, Masaki Takahashi, Yumi Ishii, Hirochika Yamasaki, Takashi Shuto, Yasushi Teshima, Tomoyuki Wada, Kunio Yufu, Hidenori Sako, Hirofumi Anai, Shinji Miyamoto, Naohiko Takahashi","doi":"10.1253/circj.CJ-26-0082","DOIUrl":"10.1253/circj.CJ-26-0082","url":null,"abstract":"Background: Because glucose fluctuations (GFs) are significantly associated with poor cardiovascular outcomes in patients with diabetes mellitus, we investigated their potential impact on the paracrine effects of human epicardial adipocytes on cardiomyocytes.Methods and results: Human epicardial adipose tissue (EAT) biopsies and isolated EAT-derived adipocytes were used to evaluate the direct impact of GFs. Mature adipocytes were exposed to media containing normal glucose (NG), high glucose (HG), or GFs. GFs altered the expression of 595 differentially expressed genes with an effect size greater than ±50% and a statistically significant difference (P<0.05) in human epicardial adipocytes, whereas continuous HG altered the expression of only 182 genes. Among the genes affected exclusively by GFs, the top 3 most affected were IL1β, IL33, and IL8. Coculture of human induced pluripotent stem cell-derived atrial cardiomyocytes and adipocytes treated with NG, HG, or GFs revealed that adipocytes exposed to GFs markedly increased oxidative stress in cardiomyocytes through paracrine effects. In a real-world clinical association study, IL1β mRNA expression in human EAT showed a significant positive correlation with the severity of GFs during hospitalization and with oxidative stress in the left atrial myocardium.Conclusions: GFs adversely affect the paracrine secretome profile of human epicardial adipocytes. IL1β may be a critical epicardial adipocyte-derived adipokine that is upregulated by GFs.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1398-1408"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665018","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

Cardiovascular-Kidney-Metabolic Syndrome Age Derived From Routine Health Checkup and Claims Data　- Large-Scale Epidemiological Study. 心血管-肾-代谢综合征年龄来自常规健康检查和索赔数据-大规模流行病学研究。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-25 Epub Date: 2026-08-28 DOI: 10.1253/circj.CJ-26-0498

Yuta Suzuki, Hidehiro Kaneko, Masachika Nishikawa, Akira Okada, Toshiyuki Ko, Takahiro Jimba, Atsushi Mizuno, Katsuhito Fujiu, Norifumi Takeda, Hiroyuki Morita, Tatsuhiko Azegami, Kaori Hayashi, Koichi Node, Hideo Yasunaga, Norihiko Takeda

{"title":"Cardiovascular-Kidney-Metabolic Syndrome Age Derived From Routine Health Checkup and Claims Data　- Large-Scale Epidemiological Study.","authors":"Yuta Suzuki, Hidehiro Kaneko, Masachika Nishikawa, Akira Okada, Toshiyuki Ko, Takahiro Jimba, Atsushi Mizuno, Katsuhito Fujiu, Norifumi Takeda, Hiroyuki Morita, Tatsuhiko Azegami, Kaori Hayashi, Koichi Node, Hideo Yasunaga, Norihiko Takeda","doi":"10.1253/circj.CJ-26-0498","DOIUrl":"10.1253/circj.CJ-26-0498","url":null,"abstract":"Background: The cardiovascular-kidney-metabolic (CKM) framework emphasizes the interplay of metabolic, renal, and cardiovascular abnormalities in cardiovascular disease risk. We aimed to develop a CKM syndrome age algorithm using routinely collected health checkup and claims data in Japan.Methods and results: We conducted a cohort study of 376,612 men and 478,853 women aged 20-79 years in the DeSC database. Flexible parametric survival models were developed for 5 incident cardiovascular outcomes corresponding to CKM syndrome stage 4 (i.e., heart failure, myocardial infarction, atrial fibrillation, stroke, and peripheral arterial disease) and a composite outcome comprising these 5 outcomes. The models used available CKM-related variables obtained from health checkups and administrative claims data. Model performance was assessed using bootstrap internal validation. CKM syndrome age was defined as the age at which a hypothetical same-sex individual with an optimal CKM risk profile would have the same predicted 5-year risk as the participant. The developed prediction models showed acceptable discrimination across the 6 outcomes, with optimism-corrected Harrell's C-index ranging from 0.694 to 0.724 in men and from 0.653 to 0.716 in women. CKM syndrome age showed higher discrimination than chronological age alone across all outcomes and both sexes.Conclusions: CKM syndrome age may serve as an intuitive tool for communicating integrated cardiovascular risk beyond chronological age in health checkup settings.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1389-1397"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860712","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

Renal Denervation for Hypertension　- Mechanisms, Evidence, and Clinical Integration. 高血压的肾去神经-机制，证据和临床整合。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-25 Epub Date: 2026-01-06 DOI: 10.1253/circj.CJ-25-1042

Takanori Sato, Yuichi Saito, Jiro Aoki, Eiichiro Yamamoto, Yuichiro Maekawa, Kazuomi Kario, Ken Kozuma, Yoshio Kobayashi

{"title":"Renal Denervation for Hypertension　- Mechanisms, Evidence, and Clinical Integration.","authors":"Takanori Sato, Yuichi Saito, Jiro Aoki, Eiichiro Yamamoto, Yuichiro Maekawa, Kazuomi Kario, Ken Kozuma, Yoshio Kobayashi","doi":"10.1253/circj.CJ-25-1042","DOIUrl":"10.1253/circj.CJ-25-1042","url":null,"abstract":"Renal denervation is a catheter-based therapy that interrupts renal sympathetic traffic and lowers blood pressure through durable neuromodulation. Contemporary catheter-based systems deliver energy to the periadventitial space with an acceptable safety profile. Across blinded placebo-controlled trials in off-medication and on-medication settings, renal denervation achieves greater reductions in ambulatory and office blood pressure than placebo, with a uniform 24-h effect that includes night-time and early-morning periods. Long-term follow-up data from randomized programs and large registries show sustained separation in blood pressure between renal denervation and control groups, preserved renal function, and low re-intervention rates over several years, with select cohorts approaching a decade. This review summarizes the mechanism and target anatomy of renal denervation, key features and results of placebo-controlled trials, and practical considerations for integrating the procedure with contemporary pharmacologic therapy in patients with uncontrolled hypertension.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1315-1325"},"PeriodicalIF":5.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901489","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

Defining Sarcopenic Obesity in the Asian Working Group for Sarcopenia 2025 Era: Diagnostic Precision Matters. 在2025年亚洲肌少症工作组中定义肌少性肥胖：诊断精度问题。

IF 5.8 3区医学

Circulation Journal Pub Date : 2026-09-25 Epub Date: 2026-09-01 DOI: 10.1253/circj.CJ-26-0902

Yoshihiro Yoshimura, Ayaka Matsumoto

引用次数: 0