Circulation Journal最新文献_第5页

Uptitration of Sacubitril/Valsartan and Outcomes in Patients With Heart Failure　- Insight From the REVIEW-HF Registry. 萨库比特利/缬沙坦的调价与心力衰竭患者的预后--REVIEW-HF 登记的启示。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-25 Epub Date: 2024-10-31 DOI: 10.1253/circj.CJ-24-0636

Shunichi Doi, Keisuke Kida, Takahito Nasu, Shunsuke Ishii, Nobuyuki Kagiyama, Wataru Fujimoto, Atsushi Kikuchi, Takeshi Ijichi, Tatsuhiro Shibata, Koshiro Kanaoka, Shingo Matsumoto, Yoshihiro J Akashi

{"title":"Uptitration of Sacubitril/Valsartan and Outcomes in Patients With Heart Failure　- Insight From the REVIEW-HF Registry.","authors":"Shunichi Doi, Keisuke Kida, Takahito Nasu, Shunsuke Ishii, Nobuyuki Kagiyama, Wataru Fujimoto, Atsushi Kikuchi, Takeshi Ijichi, Tatsuhiro Shibata, Koshiro Kanaoka, Shingo Matsumoto, Yoshihiro J Akashi","doi":"10.1253/circj.CJ-24-0636","DOIUrl":"10.1253/circj.CJ-24-0636","url":null,"abstract":"Background: Guideline-directed medical therapy has become an important component of heart failure (HF) therapy, with sacubitril/valsartan as one of the recommended drugs; however, the real-world prognostic implications of sacubitril/valsartan uptitration are unclear.Methods and results: Patients with HF newly initiated on sacubitril/valsartan were registered in a retrospective multicenter study (REVIEW-HF). In all, 995 patients were divided into 3 groups according to the maximum dose achieved: high dose, sacubitril/valsartan 400 mg; intermediate dose, sacubitril/valsartan 200-<400 mg; and low dose, sacubitril/valsartan <200 mg. A total of 397 (39.9%) patients received high-dose sacubitril/valsartan; they had a significantly lower risk of mortality or HF hospitalization than patients in the low-dose (hazard ratio [HR] 0.39; 95% confidence interval [CI] 0.29-0.53; P<0.001) and intermediate-dose (HR 0.64; 95% CI 0.45-0.94; P=0.03) groups. In the multivariable Cox regression model, higher systolic blood pressure and maintained geriatric nutritional risk index were significantly associated with a higher incidence of achieving a high dose of sacubitril/valsartan. Patients who did not receive high-dose sacubitril/valsartan experienced more hypotension during the follow-up period, whereas hyperkalemia, severe renal events, and angioedema did not differ across the achieved dose classifications.Conclusions: Patients who achieved sacubitril/valsartan uptitration had a better prognosis than those who did not. Before sacubitril/valsartan uptitration, patients need to monitor blood pressure closely to prevent worsening events.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"93-100"},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548712","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

Mitochondrial Structural Abnormalities and Cardiac Reverse Remodeling in Patients With Systolic Dysfunction. 收缩功能障碍患者的线粒体结构异常与心脏反向重塑

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-25 Epub Date: 2024-10-05 DOI: 10.1253/circj.CJ-24-0451

Koji Nakano, Masayoshi Yamamoto, Yu Yamada, Tomofumi Nakatsukasa, Naoto Kawamatsu, Kimi Sato, Tomoko Machino-Ohtsuka, Nobuyuki Murakoshi, Tomoko Ishizu

{"title":"Mitochondrial Structural Abnormalities and Cardiac Reverse Remodeling in Patients With Systolic Dysfunction.","authors":"Koji Nakano, Masayoshi Yamamoto, Yu Yamada, Tomofumi Nakatsukasa, Naoto Kawamatsu, Kimi Sato, Tomoko Machino-Ohtsuka, Nobuyuki Murakoshi, Tomoko Ishizu","doi":"10.1253/circj.CJ-24-0451","DOIUrl":"10.1253/circj.CJ-24-0451","url":null,"abstract":"Background: Mitochondrial dysfunction in the heart is associated with the development of heart failure (HF). However, the clinical consequences of mitochondrial structural abnormalities in patients with HF remain unexplored.Methods and results: Ninety-one patients with left ventricular (LV) systolic dysfunction who underwent endomyocardial biopsy (EMB) were enrolled in the study. Myocardial specimens were obtained from the right ventricular septum. Specimens were characterized using electron microscopy to assess mitochondrial size, outer membrane disruption, and cristae disorganization. The primary endpoint was a composite of cardiovascular death and unplanned hospitalization for HF. Patients were classified into LV reverse remodeling (LVRR)-positive (n=52; 57.1%) and LVRR-negative (n=39; 42.9%) groups. Cristae disorganization was observed in 21 (23.1%) patients: 6 (11.5%) in the LVRR-positive group and 15 (38.5%) in the LVRR-negative group (P=0.005). During the 1-year post-EMB observation period, 16 patients (17.6%) met the primary endpoint, with 2 (2.2%) cardiovascular deaths and 14 (15.4%) HF hospitalizations. Cristae disorganization (P=0.002) was significantly associated with the endpoints, independent of age (P=0.115), systolic blood pressure (P=0.004), B-type natriuretic peptide level (P=0.042), and mitral regurgitation (P=0.003).Conclusions: We classified mitochondrial structural abnormalities and showed that cristae disorganization was associated with LVRR and worse prognosis. These findings may affect the management of patients with HF and systolic dysfunction who undergo EMB.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"101-108"},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382217","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

Phase 3 Open-Label Study Evaluating the Efficacy and Safety of Mavacamten in Japanese Adults With Obstructive Hypertrophic Cardiomyopathy　- The HORIZON-HCM Study. 评估 Mavacamten 对日本成人阻塞性肥厚型心肌病患者疗效和安全性的 3 期开放标签研究 - HORIZON-HCM 研究。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-25 Epub Date: 2024-11-07 DOI: 10.1253/circj.CJ-24-0501

Hiroaki Kitaoka, Masaki Ieda, Mio Ebato, Ken Kozuma, Morimasa Takayama, Kaoru Tanno, Nobuyuki Komiyama, Yasushi Sakata, Yuichiro Maekawa, Yuichiro Minami, Akiyoshi Ogimoto, Tomofumi Takaya, Satoshi Yasuda, Eisuke Amiya, Yutaka Furukawa, Tetsuya Watanabe, Daigo Hiraya, Hidetaka Miyagoshi, Gen Kinoshita, Alison Reedy, Sheila M Hegde, Victoria Florea, Chisato Izumi

{"title":"Phase 3 Open-Label Study Evaluating the Efficacy and Safety of Mavacamten in Japanese Adults With Obstructive Hypertrophic Cardiomyopathy　- The HORIZON-HCM Study.","authors":"Hiroaki Kitaoka, Masaki Ieda, Mio Ebato, Ken Kozuma, Morimasa Takayama, Kaoru Tanno, Nobuyuki Komiyama, Yasushi Sakata, Yuichiro Maekawa, Yuichiro Minami, Akiyoshi Ogimoto, Tomofumi Takaya, Satoshi Yasuda, Eisuke Amiya, Yutaka Furukawa, Tetsuya Watanabe, Daigo Hiraya, Hidetaka Miyagoshi, Gen Kinoshita, Alison Reedy, Sheila M Hegde, Victoria Florea, Chisato Izumi","doi":"10.1253/circj.CJ-24-0501","DOIUrl":"10.1253/circj.CJ-24-0501","url":null,"abstract":"Background: Mavacamten, a cardiac myosin inhibitor, significantly improved symptoms and cardiac function vs. placebo in patients with symptomatic obstructive hypertrophic cardiomyopathy (HCM) in EXPLORER-HCM. However, the efficacy and safety profiles of mavacamten in Japanese patients are unclear.Methods and results: HORIZON-HCM is a Phase 3 single-arm study in Japanese patients with symptomatic obstructive HCM. The mavacamten starting dose was 2.5 mg; individualized dose titration occurred in Weeks 6-20 based on Valsalva left ventricular outflow tract (LVOT) gradient and resting left ventricular ejection fraction (LVEF). Overall, 38 patients were treated; 36 completed the 30-week primary treatment analysis period. Clinically significant improvements in postexercise LVOT gradient were observed after 30 weeks of treatment (mean change from baseline -60.7 mmHg). Improvements in N-terminal pro B-type natriuretic peptide, New York Heart Association class, and Kansas City Cardiomyopathy Questionnaire-23 Clinical Summary Score were observed over 30 weeks, and mean LVEF was ≥74% at all visits. Treatment-emergent adverse events (TEAEs) and serious TEAEs were reported in 63.2% and 7.9% of patients, respectively; none resulted in treatment discontinuation. One patient experienced a transient asymptomatic reduction in LVEF to <50%. No deaths occurred during the study.Conclusions: In Japanese patients with obstructive HCM, mavacamten was associated with similar improvements in LVOT gradients, cardiac biomarkers, and symptoms to those observed in EXPLORER-HCM. Treatment was well tolerated with no new safety concerns.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"130-138"},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592020","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

Characteristics, Treatment, and Prognosis in Octogenarian and Older Patients With Acute Heart Failure in Japan　- Prospective Observational Study on Acute Pharmacotherapy and Prognosis in Management of Acute Heart Failure (POPEYE-AHF Registry). 日本八旬和高龄急性心力衰竭患者的特征、治疗和预后--急性心力衰竭药物治疗和预后管理前瞻性观察研究（POPEYE-AHF 注册）。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-25 Epub Date: 2024-09-06 DOI: 10.1253/circj.CJ-24-0299

Tasuku Kuwayama, Takahiro Okumura, Toru Kondo, Hideo Oishi, Yuki Kimura, Shingo Kazama, Takashi Araki, Hiroaki Hiraiwa, Ryota Morimoto, Masaaki Kanashiro, Hiroshi Asano, Katsuhiro Kawaguchi, Yukihiko Yoshida, Nobukiyo Tanaka, Itsuro Morishima, Toyoaki Murohara

{"title":"Characteristics, Treatment, and Prognosis in Octogenarian and Older Patients With Acute Heart Failure in Japan　- Prospective Observational Study on Acute Pharmacotherapy and Prognosis in Management of Acute Heart Failure (POPEYE-AHF Registry).","authors":"Tasuku Kuwayama, Takahiro Okumura, Toru Kondo, Hideo Oishi, Yuki Kimura, Shingo Kazama, Takashi Araki, Hiroaki Hiraiwa, Ryota Morimoto, Masaaki Kanashiro, Hiroshi Asano, Katsuhiro Kawaguchi, Yukihiko Yoshida, Nobukiyo Tanaka, Itsuro Morishima, Toyoaki Murohara","doi":"10.1253/circj.CJ-24-0299","DOIUrl":"10.1253/circj.CJ-24-0299","url":null,"abstract":"Background: The number of older people in Japan is increasing more quickly than in other countries; with this aging of society, the number of elderly patients hospitalized for acute heart failure (HF) is also increasing. The treatment and prognosis of acute HF may be changing, but there are insufficient recent data, especially for octogenarian and older patients.Methods and results: This study investigated the characteristics and treatment of acute HF patients in Japan. From 2018 to 2020, 1,146 patients from 7 Tokai area hospitals were followed for at least 1 year. The mean age was 78 years. Compared with patients aged <80 years, those aged ≥80 years were more likely to be female (57.4% vs. 34.2%), have a lower body mass index (22.2 vs. 24.9 kg/m2), and have HF with preserved ejection fraction (43.1% vs. 21.4%), and less likely to have HF with reduced ejection fraction (38.9% vs. 61.7%). During hospitalization, 6.5% died. After discharge, patients faced high risks of rehospitalization for HF and death (27.6 and 14.2 per 100 patient-years, respectively). Notably, prescription rates of HF medications have declined over time for all patients, but especially for those aged ≥80 years.Conclusions: Guideline-directed medical therapy should be provided based on a thorough understanding of an individual's background rather than withheld simply because of clinical inertia due to a patient's advanced age.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"83-92"},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156502","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

Surgical Outcomes of Patients With Heterotaxy Syndrome　- The Japanese Congenital Cardiovascular Surgery Database. 异位综合征患者的手术效果 - 日本先天性心血管手术数据库。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-25 Epub Date: 2024-11-14 DOI: 10.1253/circj.CJ-24-0603

Keiichi Hirose, Hisateru Tachimori, Noboru Motomura, Hiroki Ito, Kisabudo Sakamoto, Yasutaka Hirata

{"title":"Surgical Outcomes of Patients With Heterotaxy Syndrome　- The Japanese Congenital Cardiovascular Surgery Database.","authors":"Keiichi Hirose, Hisateru Tachimori, Noboru Motomura, Hiroki Ito, Kisabudo Sakamoto, Yasutaka Hirata","doi":"10.1253/circj.CJ-24-0603","DOIUrl":"10.1253/circj.CJ-24-0603","url":null,"abstract":"Background: Cardiac malformations are a major component of heterotaxy syndrome and result in significant mortality and morbidity. This multicenter nationwide Japanese study evaluated mortality and morbidity after initial surgical palliation for patients with heterotaxy syndrome and determined predictors for mortality and morbidity among patients enrolled in the study.Methods and results: The Japanese Congenital Cardiovascular Surgery Database (JCCVSD) collects clinical data from 119 domestic institutions specializing in congenital heart disease, covering almost all major congenital heart surgery programs in Japan. Clinical data on preoperative, operative, and postoperative characteristics and survival data within 30 and 90 days were available from the JCCVSD database. Of the 561 patients with heterotaxy syndrome who underwent any of 8 specific initial cardiovascular surgeries, 45 (8.2%) and 75 (13.4%) had died at 30 and 90 days, respectively. Preoperative emergency transport, type of heterotaxy syndrome, low hospital volume, the repair of total anomalous pulmonary vein connection, and the repair of a common atrioventricular valve were identified as significant predictive factors for operative mortality.Conclusions: Improvements in some medical circumstances, such as fetal diagnosis and the patient transport system, will be needed to improve outcomes for severely ill patients with heterotaxy syndrome. This study describes early outcomes for the largest number of main cardiovascular surgeries to date in infants with heterotaxy syndrome.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"69-76"},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631962","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

Maternal Death Due to Pulmonary Arterial Hypertension　- A Nationwide Survey in Japan. 肺动脉高压导致的产妇死亡--日本全国调查。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-25 Epub Date: 2024-11-26 DOI: 10.1253/circj.CJ-24-0602

Chizuko Aoki-Kamiya, Shinji Katsuragi, Yumi Shiina, Junichi Hasegawa, Jun Yoshimatsu, Akihito Nakai, Isamu Ishiwata, Akihiko Sekizawa, Tomoaki Ikeda

{"title":"Maternal Death Due to Pulmonary Arterial Hypertension　- A Nationwide Survey in Japan.","authors":"Chizuko Aoki-Kamiya, Shinji Katsuragi, Yumi Shiina, Junichi Hasegawa, Jun Yoshimatsu, Akihito Nakai, Isamu Ishiwata, Akihiko Sekizawa, Tomoaki Ikeda","doi":"10.1253/circj.CJ-24-0602","DOIUrl":"10.1253/circj.CJ-24-0602","url":null,"abstract":"Background: With advances in treatment, the prognosis for pregnancies complicated by pulmonary arterial hypertension (PAH) has been improving. However, PAH-related maternal mortality remains high compared with that due to other cardiovascular diseases. The specifics of PAH-related maternal deaths under advanced medical standards are not well understood.Methods and results: We used the maternal death registration system established by the Japan Association of Obstetricians and Gynecologists and reviewed 6 PAH-related maternal deaths from 2010 to 2022. All women were initially diagnosed with PAH during pregnancy or immediately after childbirth. The diagnosis of PAH tended to be delayed because symptoms were not reported to healthcare providers and/or a different disease was diagnosed. Cardiogenic shock occurred antepartum in 1 woman and during delivery or within 7 days after delivery in the other 5 women. Four women were resuscitated and started on extracorporeal membrane oxygenation. Pulmonary vasodilators were initiated in 4 women, with a median duration of 8 days from PAH diagnosis to starting medication. Right heart failure was the most common cause of maternal death, with a median duration of 16 days from PAH diagnosis to maternal death.Conclusions: All PAH-related maternal deaths occurred in women who were diagnosed with PAH after pregnancy. Diagnosing PAH and initiating pulmonary vasodilators takes considerable time, highlighting the importance of early diagnosis and early treatment.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"77-82"},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741254","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

Medical Therapy and Clinical Outcomes in Cardiac Sarcoidosis Patients With Systolic Heart Failure. 患有收缩性心力衰竭的心脏肉样瘤病患者的药物治疗和临床疗效。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-25 Epub Date: 2024-09-03 DOI: 10.1253/circj.CJ-24-0205

Daniel Sykora, Melanie Bratcher, Robert Churchill, B Michelle Kim, Mohamed Elwazir, Kathleen Young, Sami Ryan, Nikhil Kolluri, Omar Abou Ezzeddine, John Bois, John Giudicessi, Leslie Cooper, Andrew Rosenbaum

{"title":"Medical Therapy and Clinical Outcomes in Cardiac Sarcoidosis Patients With Systolic Heart Failure.","authors":"Daniel Sykora, Melanie Bratcher, Robert Churchill, B Michelle Kim, Mohamed Elwazir, Kathleen Young, Sami Ryan, Nikhil Kolluri, Omar Abou Ezzeddine, John Bois, John Giudicessi, Leslie Cooper, Andrew Rosenbaum","doi":"10.1253/circj.CJ-24-0205","DOIUrl":"10.1253/circj.CJ-24-0205","url":null,"abstract":"Background: Cardiac sarcoidosis (CS) may result in systolic heart failure (heart failure with reduced ejection fraction [HFrEF]), but its response to guideline-directed medical therapy (GDMT) remains uncertain.Methods and results: We investigated 881 patients evaluated for CS to identify those with diagnosed CS, left ventricular ejection fraction (LVEF) ≤40% at diagnosis, and follow-up echocardiogram within 11-24 months. Demographics, LVEF, GDMT as quantified by Kansas City Medical Optimization (KCMO) score, and immunosuppressive treatment were recorded. The primary outcome was a composite of event-free survival (unplanned heart failure hospitalization, left ventricular assist device [LVAD]/heart transplant, or death). Seventy-nine (9%) CS patients met the inclusion criteria (35% female, median age 57 years, mean LVEF 30.9%, median New York Heart Association class II [46%], mean number of GDMT agents 1.7, and mean KCMO score 31.8). Most (87%) were treated with immunosuppressive treatment. At follow-up (median 16 months), the mean number of GDMT agents increased to 2.2 (P=0.02), and the mean KCMO score to 70.1 (P<0.001). Mean LVEF improved to 39.9% (excluding LVAD/transplant; P<0.001) and the change in LVEF was correlated with follow-up KCMO score (P<0.001). The primary outcome occurred in 13 (16%) patients and differed by KCMO score (log-rank P<0.001), but not by immunosuppressive treatment (log-rank P=0.36).Conclusions: GDMT optimization is associated with better cardiac remodeling and clinical outcomes in CS patients with HFrEF.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"41-52"},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134327","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

Prospective Multicenter Screening With High-Sensitivity Cardiac Troponin T for Wild-Type Transthyretin Cardiac Amyloidosis in Outpatient and Community-Based Settings. 在门诊和社区环境中使用高敏心肌肌钙蛋白 T 对野生型转甲状腺素心脏淀粉样变性进行前瞻性多中心筛查。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-25 Epub Date: 2024-10-04 DOI: 10.1253/circj.CJ-24-0479

Naoki Arima, Yuri Ochi, Toru Kubo, Yoshinori Murakami, Kiyoshi Nishino, Hironori Yamamoto, Koji Satou, Shinjiro Tamura, Makoto Okawa, Hiroshi Takata, Yuji Shimizu, Yuichi Baba, Naohito Yamasaki, Hiroaki Kitaoka

{"title":"Prospective Multicenter Screening With High-Sensitivity Cardiac Troponin T for Wild-Type Transthyretin Cardiac Amyloidosis in Outpatient and Community-Based Settings.","authors":"Naoki Arima, Yuri Ochi, Toru Kubo, Yoshinori Murakami, Kiyoshi Nishino, Hironori Yamamoto, Koji Satou, Shinjiro Tamura, Makoto Okawa, Hiroshi Takata, Yuji Shimizu, Yuichi Baba, Naohito Yamasaki, Hiroaki Kitaoka","doi":"10.1253/circj.CJ-24-0479","DOIUrl":"10.1253/circj.CJ-24-0479","url":null,"abstract":"Background: High-sensitivity cardiac troponin T (hs-cTnT) was proposed as a simple and useful diagnostic tool for cardiac amyloidosis (CA). We performed exploratory systemic screening using hs-cTnT to detect wild-type transthyretin CA (ATTRwt-CA) in outpatient and community-based settings.Methods and results: This study was a prospective multicenter study including 8 internal medicine clinics in Kochi Prefecture, Japan. Consecutive individuals aged ≥70 years who visited those clinics as outpatients were enrolled. Patients with a prior diagnosis of CA or a history of heart failure hospitalization were excluded. We measured hs-cTnT levels in the enrolled individuals at each clinic, and those with elevated hs-cTnT levels (≥0.03ng/mL) received further detailed examination, including remeasurement of hs-cTnT. The diagnosis of ATTRwt-CA was confirmed by biopsy-proven transthyretin. Of 1,141 individuals enrolled in the study, 55 (4.8%) had elevated hs-cTnT levels. Of the 33 patients who underwent further examination, 22 had elevated hs-cTnT levels at remeasurement. Finally, 2 men were diagnosed with ATTRwt-CA. The prevalence of ATTRwt-CA was 9.1% (2/22) among patients with elevated hs-cTnT levels at two examinations, and at least 0.18% (2/1,141) in the whole study population.Conclusions: Measurement of hs-cTnT will help to screen for patients with undiagnosed ATTRwt-CA in primary care practice.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"24-30"},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382218","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

Tribute to Dr. Chuichi Kawai　- A Great Cardiologist in Japan. 向日本伟大的心脏病专家川井忠一博士致敬。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-25 Epub Date: 2024-12-06 DOI: 10.1253/circj.CJ-66-0232

Koh Ono, Hisayoshi Fujiwara

引用次数: 0

Regional Collaboration for Heart Failure Patients Certified as Needing Support or Care in Long-Term Care Insurance System. 长期护理保险系统中被认定为需要支持或护理的心衰患者的地区合作。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-12-25 Epub Date: 2024-08-24 DOI: 10.1253/circj.CJ-24-0466

Yoshiharu Kinugasa, Kensuke Nakamura, Masayuki Hirai, Midori Manba, Natsuko Ishiga, Takeshi Sota, Natsuko Nakayama, Tomoki Ota, Masahiko Kato, Toshiaki Adachi, Masaharu Fukuki, Yutaka Hirota, Einosuke Mizuta, Emiko Mura, Yoshihito Nozaka, Hiroki Omodani, Hiroaki Tanaka, Yasunori Tanaka, Izuru Watanabe, Masaaki Mikami, Kazuhiro Yamamoto

{"title":"Regional Collaboration for Heart Failure Patients Certified as Needing Support or Care in Long-Term Care Insurance System.","authors":"Yoshiharu Kinugasa, Kensuke Nakamura, Masayuki Hirai, Midori Manba, Natsuko Ishiga, Takeshi Sota, Natsuko Nakayama, Tomoki Ota, Masahiko Kato, Toshiaki Adachi, Masaharu Fukuki, Yutaka Hirota, Einosuke Mizuta, Emiko Mura, Yoshihito Nozaka, Hiroki Omodani, Hiroaki Tanaka, Yasunori Tanaka, Izuru Watanabe, Masaaki Mikami, Kazuhiro Yamamoto","doi":"10.1253/circj.CJ-24-0466","DOIUrl":"10.1253/circj.CJ-24-0466","url":null,"abstract":"Background: Heart failure (HF) patients with complex care needs often experience exacerbations during the transitional phase as care providers and settings change. Regional collaboration aims to ensure continuity of care; however, its impact on vulnerable patients certified as needing support or care under the Japanese long-term care insurance (LTCI) system remains unclear.Methods and results: We implemented a regional collaborative program for HF patients involving 3 pillars of transitional care with general practitioners and nursing care facilities: (1) standardized health monitoring using a patient diary and identification of exacerbation warning signs; (2) standardized information sharing among care providers; and (3) standardized HF management manuals. We evaluated outcomes within 1 year of discharge for patients hospitalized with HF and referred to other facilities for outpatient follow-up in 2017-2018 before program implementation (n=110) and in 2019-2020 after implementation (n=126). Patients with LTCI frequently received non-cardiologist follow up and care services and had a higher risk of all-cause mortality and HF readmission compared with those without LTCI (P<0.05). Program implementation was significantly associated with a greater reduction in HF readmissions among patients with LTCI compared with those without (P<0.05 for interaction), although mortality rates remained unchanged.Conclusions: A regional collaborative program significantly reduces HF readmissions in HF patients with LTCI who are at high risk of worsening HF.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"109-119"},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057193","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}

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