Circulation Journal最新文献

{"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":"https://doi.org/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":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-21","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}

{"title":"Sex Differences in Sudden Cardiac Death During Long-Term Follow-up in Patients With Chronic Heart Failure　- A Report From the CHART-2 Study.","authors":"Hideka Hayashi, Kotaro Nochioka, Makoto Nakano, Takashi Shiroto, Yuhi Hasebe, Takashi Noda, Satoshi Miyata, Hiroaki Shimokawa, Satoshi Yasuda","doi":"10.1253/circj.CJ-24-0484","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0484","url":null,"abstract":"<p><strong>Background: </strong>Although sudden cardiac death (SCD) generally occurs more frequently in men than in women, there are limited data on sex differences in SCD in patients with chronic heart failure (HF) across a range of left ventricular ejection fraction (LVEF).</p><p><strong>Methods and results: </strong>We examined sex differences in SCD incidence, timing, and risk factors in 4,683 patients with chronic HF (3,186 men, 1,497 women) from a multicenter prospective observational cohort study (CHART-2). Over a median follow-up of 8.8 years after study enrollment, there were 215 SCDs (160 in men, 55 in women). The SCD incidence rates in men and women were 6.1 and 4.6 per 1,000 person-years, respectively (P=0.088). Among women, more than half the SCDs occurred in the first 5 years of follow-up. Beyond 5 years, the SCD incidence rate was significantly lower in women than in men (3.6 vs. 5.9 per 1,000 person-years, respectively; P=0.044). After adjusting for confounders, age, increased B-type natriuretic peptide, and LVEF <50% were common prognostic factors. After 5 years of follow-up, left ventricular (LV) enlargement was a risk factor for SCD in both sexes.</p><p><strong>Conclusions: </strong>These results indicate that there are sex differences in SCD, especially beyond 5 years of follow-up, with a lower prevalence in women. LV enlargement is a common long-term prognostic factor in both sexes, suggesting the importance of preventing LV remodeling in HF management.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015444","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":"Coronary Artery Calcification on Chest Computed Tomography as a Predictor of Cardiovascular Adverse Events in Patients With COVID-19　- A Multicenter Retrospective Study in Japan.","authors":"Mayuko Watase, Yusuke Shiraishi, Shotaro Chubachi, Naoya Tanabe, Tomoki Maetani, Takanori Asakura, Ho Namkoong, Hiromu Tanaka, Takashi Shimada, Shuhei Azekawa, Shiro Otake, Takahiro Fukushima, Kensuke Nakagawara, Katsunori Masaki, Hideki Terai, Takao Mochimaru, Mamoru Sasaki, Soichiro Ueda, Yukari Kato, Norihiro Harada, Shoji Suzuki, Shuichi Yoshida, Hiroki Tateno, Yoshitake Yamada, Masahiro Jinzaki, Yukinori Okada, Ryuji Koike, Makoto Ishii, Akinori Kimura, Seiya Imoto, Satoru Miyano, Seishi Ogawa, Takanori Kanai, Koichi Fukunaga","doi":"10.1253/circj.CJ-24-0661","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0661","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery calcification (CAC) detected through chest computed tomography (CT) strongly predicts cardiovascular events in asymptomatic individuals undergoing primary prevention. Few studies with limited sample sizes have investigated the predictive value of CAC for cardiovascular complications in COVID-19. This study examined the impact of CAC on cardiovascular complications using a large-scale COVID-19 database.</p><p><strong>Methods and results: </strong>This multicenter retrospective cohort study used data from the Japan COVID-19 Task Force database. After exclusion based on missing information, 1,109 patients with COVID-19 were included. The Agatston score was used to evaluate CAC, dividing the population into 3 groups based on calcification degree (no, moderate, and severe CAC). The primary outcome was cardiovascular complications; the secondary outcome was critical outcomes. The severe CAC group had a higher rate of cardiovascular complications than the other groups. Multivariable analysis, considering COVID-19 severity factors, identified severe CAC as independently associated with cardiovascular complications but not with critical outcomes. Subgroup analysis revealed that, in patients without hypertension, diabetes, cardiovascular disease, or chronic kidney disease, severe CAC was significantly correlated with cardiovascular complications, whereas this association was not observed in patients with these underlying conditions.</p><p><strong>Conclusions: </strong>Patients with COVID-19 and severe CAC had increased cardiovascular complications, and identifying cardiovascular and pulmonary findings on chest CT is essential. Measuring CAC via non-electrocardiogram-gated CT helps predict patient risk.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015437","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":"Accelerated Early Discharge and Clinical Outcomes in Heart Failure Patients With Cardiac Implantable Electronic Devices　- Subanalysis From a Multicenter Cohort Study.","authors":"Seyong Chung, Tae-Hoon Kim, Torri Schwartz, Torsten Kayser, Kazutaka Aonuma","doi":"10.1253/circj.CJ-24-0675","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0675","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have demonstrated that a shorter hospital stay reduces adverse outcomes in heart failure (HF), primarily in observational study settings. This trend was further emphasized during the COVID-19 pandemic, resulting in case-control study-like results.</p><p><strong>Methods and results: </strong>A subanalysis was conducted on 239 patients from a Japanese multicenter cohort study (HINODE), encompassing 32 months before and 6 months after pandemic onset. The duration of hospitalization and clinical outcomes were compared between these 2 periods in HF patients who received guideline-directed medical and cardiac implantable electronic device (CIED) therapy. The duration of HF hospitalization was significantly shortened by 41.1% (95% confidence interval [CI] 6.7-62.8%) during the pandemic period (median 13 days; interquartile range [IQR] 6-19 days) compared with the prepandemic period (median 21 days; IQR 12-38 days). Nonetheless, the incidence rate (IR) of outcomes in the pandemic group was similar (ventricular arrhythmia, HF events, HF and cardiac hospitalization) or lower (all-cause hospitalization [IR ratio 0.6; 95% CI 0.4-1.0]) compared with the prepandemic group. The odds ratio of adverse events was also similar between the 2 groups.</p><p><strong>Conclusions: </strong>A significant reduction in hospitalization duration during the COVID-19 pandemic was associated with similar or improved clinical outcomes for guideline-adherent HF patients. Current hospitalization durations for advanced HF patients are likely unnecessarily long, and efforts to reduce them are warranted.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015435","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":"Safety and Efficacy of Selexipag for Pediatric Pulmonary Arterial Hypertension in Japanese Patients　- An Open-Label Phase 2 Study.","authors":"Toru Iwasa, Ryo Inuzuka, Hiroshi Ono, Yuichiro Sugitani, Hirokuni Yamazawa, Chihiro Hiraishi, Naoki Shiota, Shinichi Tanaka, Chieko Yamamoto, Ken-Ichi Kurosaki, Masaru Miura, Satoshi Yasukochi","doi":"10.1253/circj.CJ-24-0429","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0429","url":null,"abstract":"<p><strong>Background: </strong>Selexipag, an oral prostacyclin (PGI₂) receptor agonist, is approved for adult patients with pulmonary arterial hypertension (PAH). This study evaluated the efficacy and safety of selexipag for Japanese pediatric patients with PAH.</p><p><strong>Methods and results: </strong>The study enrolled 6 patients who received selexipag twice daily at an individualized dose based on body weight; maintenance doses were determined for each patient by 12 weeks after starting administration. Efficacy, including pulmonary hemodynamics, was evaluated after 16 weeks, and efficacy and safety were further evaluated 52 weeks after treatment was initiated in the last enrolled patient. The mean (±SD) change in the pulmonary vascular resistance index from baseline to Week 16 (the primary endpoint of the study) was -5.55±6.88 Wood units·m²; improvements were also seen in other pulmonary hemodynamic parameters. The 6-min walk distance increased and N-terminal pro-B-type natriuretic peptide decreased up to Week 64, but the between-subject variability was large. The World Health Organization functional class was improved in 1 of 6 patients at Week 16 and in 2 of 4 patients at Week 64. No patient worsened. The major side effects of selexipag were those characteristic of PGI₂, and the safety profile of selexipag was similar to that in adult patients.</p><p><strong>Conclusions: </strong>The efficacy and safety of selexipag in Japanese pediatric patients with PAH were demonstrated.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015439","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":"Association Between Sodium- and Potassium-Related Urinary Markers and the Prevalence of Atrial Fibrillation.","authors":"Sayuri Tokioka, Naoki Nakaya, Rieko Hatanaka, Kumi Nakaya, Mana Kogure, Ippei Chiba, Masato Takase, Kotaro Nochioka, Kai Susukita, Hirohito Metoki, Tomohiro Nakamura, Mami Ishikuro, Taku Obara, Yohei Hamanaka, Masatsugu Orui, Tomoko Kobayashi, Akira Uruno, Eiichi N Kodama, Satoshi Nagaie, Soichi Ogishima, Yoko Izumi, Nobuo Fuse, Shinichi Kuriyama, Satoshi Yasuda, Atsushi Hozawa","doi":"10.1253/circj.CJ-24-0780","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0780","url":null,"abstract":"<p><strong>Background: </strong>The primary prevention of atrial fibrillation (AF), which increases mortality through complications including stroke and heart failure, is important. Excessive salt intake and low potassium intake are risk factors for cardiovascular disease; however, their association with AF remains inconclusive. This study investigated the association between sodium- and potassium-related urinary markers and AF prevalence.</p><p><strong>Methods and results: </strong>Data from the Tohoku Medical Megabank Project Community-based Cohort Study were used in this cross-sectional study. The urinary sodium-to-potassium (Na/K) ratio and estimated 24-h sodium and potassium excretion were calculated using spot urine samples and categorized into quartiles (Q1-Q4). The prevalence of AF was the primary outcome. Of the 26,506 participants (mean age 64.8 years; 33.2% males) included in this study, 630 (2.4%) had AF. Using Q1 as the reference group, the odds ratios for AF prevalence in Q4 were 1.35 (95% confidence interval [CI] 1.07-1.73) and 1.59 (95% CI 1.20-2.12) for 24-h estimated urinary Na/K ratio and estimated 24-h sodium excretion, respectively. Estimated 24-h potassium excretion was not associated with AF prevalence.</p><p><strong>Conclusions: </strong>AF prevalence was positively associated with the urinary Na/K ratio and estimated 24-h urinary sodium excretion, but not with estimated 24-h urinary potassium excretion. Although further prospective studies are warranted, the findings of this study suggest that salt intake may be a modifiable risk factor for AF.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980569","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":"https://doi.org/10.1253/circj.CJ-24-0606","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-11","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":"Long-Term Effect of Tafamidis on Clinical Parameters and Prognostic Predictors in Patients With Transthyretin Amyloid Cardiomyopathy.","authors":"Naoto Kuyama, Yasuhiro Izumiya, Seiji Takashio, Hiroki Usuku, Akihisa Tabira, Tetsuya Oguni, Masahiro Yamamoto, Kyoko Hirakawa, Masanobu Ishii, Noriaki Tabata, Tadashi Hoshiyama, Hisanori Kanazawa, Shinsuke Hanatani, Masafumi Kidoh, Seitaro Oda, Yasushi Matsuzawa, Eiichiro Yamamoto, Toshinori Hirai, Mitsuharu Ueda, Kenichi Tsujita","doi":"10.1253/circj.CJ-24-0733","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0733","url":null,"abstract":"<p><strong>Background: </strong>Accurate prediction of prognosis in transthyretin amyloid cardiomyopathy (ATTR-CM) is crucial for optimal treatment selection, including tafamidis, the only approved therapy for ATTR-CM. Although tafamidis has been proven to improve prognosis, the long-term serial changes in comprehensive parameters related to ATTR-CM, including cardiac biomarkers and imaging parameters, under tafamidis remain unknown.</p><p><strong>Methods and results: </strong>In this study, we used Cox regression analysis on data from 258 consecutive patients diagnosed with ATTR-CM at Kumamoto University to determine prognostic factors. During clinical follow-up, the serial changes in parameters were compared between tafamidis-treated and tafamidis-naïve patients. An elevated high-sensitivity cardiac troponin T (hs-cTnT) level at baseline was identified as a stronger independent predictor of all-cause death compared with left ventricular ejection fraction (LVEF) and extracellular volume. During follow-up (median: 24.4 months), estimated glomerular filtration rate and LVEF declined significantly with time in both cohorts. Notably, serum hs-cTnT and B-type natriuretic peptide levels were significantly elevated in the tafamidis-naïve cohort compared to baseline, but this increase was prevented by tafamidis treatment.</p><p><strong>Conclusions: </strong>Of the ATTR-CM-related parameters investigated, an increased hs-cTnT level at baseline was a promising determinant of poor prognosis. Long-term tafamidis treatment prevented a deterioration in cardiac biomarkers, and the measurement of these markers may enable appropriate monitoring of disease progression.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958331","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":"Coronary Artery Injury Related to Catheter Ablation for Cardiac Arrhythmias　- A Systematic Review.","authors":"Kanae Hasegawa, Hiroshi Tada","doi":"10.1253/circj.CJ-24-0859","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0859","url":null,"abstract":"<p><p>Catheter ablation is a widely used treatment modality for various cardiac tachyarrhythmias, including atrial and ventricular arrhythmias. Although it is generally considered safe, the procedure carries potential complications, with coronary artery injury being one of the most significant. The aim of this systematic review was to assess the incidence, mechanisms, contributing factors, diagnostic strategies, and preventive measures related to coronary artery injury in patients undergoing catheter ablation, including radiofrequency catheter ablation, cryoablation, and pulsed-field ablation.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958327","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":"https://doi.org/10.1253/circj.CJ-24-0806","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-08","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}