{"title":"Colchicine as a Potential Anti-Inflammatory Strategy for Aortic Aneurysm.","authors":"Tadayoshi Karasawa, Masafumi Takahashi","doi":"10.1253/circj.CJ-25-0703","DOIUrl":"https://doi.org/10.1253/circj.CJ-25-0703","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016511","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":"Aspirin-Free Prasugrel Monotherapy After Percutaneous Coronary Intervention in Patients With Non-ST Elevation Acute Coronary Syndrome.","authors":"Kotaro Miyashita, Takashi Muramatsu, Pruthvi C Revaiah, Gaku Nakazawa, Yuki Ishibashi, Ken Kozuma, Taku Asano, Yuki Katagiri, Takayuki Okamura, Yoshihiro Morino, Norihiro Kogame, Masafumi Ono, Yosuke Miyazaki, Shimpei Nakatani, Masato Nakamura, Akihiro Tobe, Asahi Oshima, Tsung Ying-Tsai, Scot Garg, Kengo Tanabe, Yukio Ozaki, Patrick W Serruys, Yoshinobu Onuma","doi":"10.1253/circj.CJ-25-0356","DOIUrl":"https://doi.org/10.1253/circj.CJ-25-0356","url":null,"abstract":"<p><strong>Background: </strong>In the presence of a potent P2Y<sub>12</sub>inhibitor such as prasugrel, the additional clinical antithrombotic benefit of aspirin is unclear. The feasibility of prasugrel monotherapy without aspirin after percutaneous coronary intervention (PCI) has been demonstrated in chronic coronary syndrome, but is yet to be assessed in patients with non-ST elevation acute coronary syndrome (NSTE-ACS) and low anatomical complexity.</p><p><strong>Methods and results: </strong>ASET-Japan is a single-arm study investigating the safety of prasugrel 12-month monotherapy with a locally approved dose (loading 20 mg; maintenance 3.75 mg), started immediately after successful PCI using platinum-chromium everolimus-eluting SYNERGY stents. The primary ischemic endpoint is a composite of cardiac death, spontaneous target vessel myocardial infarction, or definite stent thrombosis; the primary bleeding endpoint is Bleeding Academic Research Consortium (BARC) Type 3 and 5 bleeding. ASET-Japan recruited 101 NSTE-ACS patients from 11 Japanese sites. The mean (±SD) age was 69.1±12.3 years and 36.6% had a PRECISE-DAPT score >25. The mean anatomical SYNTAX score was 7.9±4.7. At 1 year, the primary ischemic endpoint occurred in 1 patient (1.0%; cardiac death). Two BARC Type 3a bleeding events occurred (2.0%): 1 due to a gastric ulcer and 1 to a descending colon malignancy.</p><p><strong>Conclusions: </strong>Low-dose (3.75 mg/day) prasugrel monotherapy started immediately after SYNERGY stent deployment was feasible and safe in selected NSTE-ACS patients.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994415","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}
Dimitar P Zankov, Mend Amar Batbaatar, Hirotsugu Tsuchimochi, Shigeyoshi Saito, Ming Zhu, Yoshitaka Fujihara, Keiko Sonoda, Seiko Ohno
{"title":"Biventricular Dysfunction in Knock-in Mice With Dsg2 Variants Specific for Japanese Arrhythmogenic Right Ventricular Cardiomyopathy.","authors":"Dimitar P Zankov, Mend Amar Batbaatar, Hirotsugu Tsuchimochi, Shigeyoshi Saito, Ming Zhu, Yoshitaka Fujihara, Keiko Sonoda, Seiko Ohno","doi":"10.1253/circj.CJ-25-0269","DOIUrl":"https://doi.org/10.1253/circj.CJ-25-0269","url":null,"abstract":"<p><strong>Background: </strong>Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited disease with a poor prognosis and no curative therapy. It may present as arrhythmogenic sudden cardiac death and inevitably progress to terminal heart failure due to the loss of contractile tissue. This study aimed to generate knock-in (KI) mice carrying the 2 genetic variants (DSG2 p.R292C and p.D494A) most frequently found in Japanese ARVC patients, characterize their cardiac phenotype, and compare the results with those of human ARVC.</p><p><strong>Methods and results: </strong>Variants were introduced using CRISPR/Cas9 genome editing at the corresponding mouse locations: Dsg2 p.R297C (RC) and p.D499A (DA). Cardiac function, morphology, and electrophysiology were evaluated using echography, magnetic resonance imaging, and telemetry. Tissue and cardiomyocytes were examined histologically. All mice with the variants developed biventricular cardiac dysfunction after 8 weeks of age, and it progressed with age. There was a significant variability in phenotype expression. Mice with RC died suddenly at 9 weeks of age. Some homozygous RC mice showed arrhythmia and conduction abnormalities on telemetry. In both variants, staining of cardiac sections revealed significant fibrosis, and apoptosis was detected using the terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling assay.</p><p><strong>Conclusions: </strong>We generated a KI ARVC mouse model with significant similarities to human disease. This model could be used for the elucidation of pathogenesis and the development of optimal therapy for ARVC.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977142","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":"Cancer-Associated Thrombosis, With a Focus on Ischemic Heart Disease.","authors":"Tomoya Hara, Masataka Sata","doi":"10.1253/circj.CJ-25-0627","DOIUrl":"https://doi.org/10.1253/circj.CJ-25-0627","url":null,"abstract":"<p><p>Cancer is widely recognized as one of the major risk factors for thrombosis, and cancer-associated thrombosis (CAT) is a concept that also encompasses arterial and venous thromboembolism. The risk factors for CAT of clinical concern are assumed to be a complex combination of patient-related factors, the cancer itself, factors related to anticancer therapy, tissue factors expressed on cancer cell membranes, and cytokines released by cancer cells to increase inflammation and coagulation at remote sites. In addition, some anticancer agents are known to damage vascular endothelial cells and cause thrombus formation; early diagnosis and treatment of CAT is recommended because CAT is a significant risk factor for poor prognosis in cancer patients.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977131","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 Post-Noncardiac Surgery Risks Assessed Using the Revised Cardiac Risk Index - A Nationwide Retrospective Cohort Study.","authors":"Tomohisa Seki, Yoshimasa Kawazoe, Toru Takiguchi, Yu Akagi, Hiromasa Ito, Kazumi Kubota, Kana Miyake, Masafumi Okada, Kazuhiko Ohe","doi":"10.1253/circj.CJ-24-0846","DOIUrl":"10.1253/circj.CJ-24-0846","url":null,"abstract":"<p><strong>Background: </strong>The Revised Cardiac Risk Index (RCRI) has been incorporated into preoperative assessment guidelines and is used for simple preoperative screening; however, validation studies within large populations are limited. Moreover, although sex differences in perioperative risk are recognized, their effect on the performance of the RCRI remains unclear. Therefore, in this study we evaluated whether sex differences exist in the risks within the strata classified by the RCRI.</p><p><strong>Methods and results: </strong>The Japan Medical Data Center database based on claim and health examination data in Japan between January 2005 and April 2021 was used. A total of 161,359 noncardiac surgeries performed during hospitalization were analyzed. The main outcome was the 30-day risk of major adverse cardiovascular events. Although there was no significant sex difference among those with an RCRI ≥1, males had a significant hazard rate (1.32 [95% confidence interval, 1.03-1.68]) of postoperative events in the low-risk group with an RCRI of 0. However, this significant difference was not detected in the population excluding those who underwent breast and gynecological surgeries.</p><p><strong>Conclusions: </strong>The RCRI achieved reasonable risk stratification in validation using Japanese real-world data regardless of sex. Although further detailed analysis is necessary to determine the sex differences, the validity of using the RCRI for screening purposes is supported at this stage.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1547-1554"},"PeriodicalIF":3.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434219","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":"Body Mass Index Affects Hospital-Associated Disability and Economic Burden in Elective Cardiovascular Surgery - JROAD/JROAD-DPC Database.","authors":"Masato Ogawa, Kodai Ishihara, Yuji Kanejima, Naofumi Yoshida, Koshiro Kanaoka, Yoko Sumita, Yoshitaka Iwanaga, Yoshihiro Miyamoto, Tomoya Yamashita, Yoshitada Sakai, Ken-Ichi Hirata, Kazuhiro P Izawa","doi":"10.1253/circj.CJ-24-0901","DOIUrl":"10.1253/circj.CJ-24-0901","url":null,"abstract":"<p><strong>Background: </strong>Both underweight and overweight are recognized as important factors influencing outcomes in patients undergoing cardiovascular surgery. This study investigated the effects of body mass index (BMI) on hospital-associated disability (HAD) and hospitalization costs in patients undergoing elective cardiovascular surgery (coronary artery bypass grafting, valve surgery, aortic surgery) by analyzing data from the Japanese Registry of All Cardiac and Vascular Diseases - Diagnosis Procedure Combination (JROAD-DPC) database.</p><p><strong>Methods and results: </strong>All patients in the JROAD-DPC database were categorized into 5 groups according to the World Health Organization BMI criteria for Asians. HAD was defined as a decrease of ≥5 points in the Barthel Index from admission to discharge. The primary outcome was the prevalence of HAD, and the secondary outcome was hospitalization costs. Among the 228,891 patients included in the study, the median BMI was 23.2 kg/m<sup>2</sup>. The prevalence of HAD was 8.7%, with a U-shaped relationship between BMI and HAD, indicating that both extremely low and high BMIs were associated with a higher incidence of HAD. Hospitalization costs also showed a U-shape relationship with BMI, with higher costs for patients with HAD.</p><p><strong>Conclusions: </strong>Low BMI in any age group was associated with HAD, and older people with a BMI considered too high also had HAD. BMI could be an important risk stratification tool for functional outcomes and economic burden in patients undergoing elective cardiovascular surgery.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1538-1546"},"PeriodicalIF":3.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659505","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":"Quantification of Pulmonary Regurgitation After Surgical Repair of Tetralogy of Fallot Using Vector Flow Mapping.","authors":"Junpei Kawamura, Satoshi Yasukochi, Kiyohiro Takigiku, Kohta Takei, Yuko Saikawa, Tomohide Nishiyama, Tomohiko Tanaka, Takashi Okada","doi":"10.1253/circj.CJ-24-0273","DOIUrl":"10.1253/circj.CJ-24-0273","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary valvular regurgitation in postoperative patients with repaired tetralogy of Fallot (rTOF) significantly impairs exercise capacity and causes right heart failure. Quantitative evaluation of the pulmonary valvular regurgitation fraction (PRF) by cardiac magnetic resonance (CMR) is commonly used to determine the indication for surgical or catheter interventions, but less commonly using echocardiography.</p><p><strong>Methods and results: </strong>We retrospectively investigated the feasibility and validation of vector flow mapping (VFM) for the quantification of PRF (VFM-PRF) in 34 pediatric patients with rTOF, comparing it to CMR-derived PRF (CMR-PRF) and other qualitative or semiquantitative echocardiographic indices. Each predictive value for CMR-PRF ≥40% was assessed using receiver operating characteristic curves. VFM-PRF and CMR-PRF showed good agreement, with a correlation coefficient of 0.90 and the highest predictive value for CMR-PRF ≥40%, resulting in an area under the curve of 0.93. Other conventional echocardiographic parameters demonstrated poor predictive accuracy.</p><p><strong>Conclusions: </strong>This is the first report to demonstrate the accurate quantification of PRF by echocardiography using VFM in pediatric patients with rTOF, showing good agreement with CMR results. Particularly in children, VFM may be clinically useful in determining the indication for reintervention for pulmonary valve replacement, offering a possible alternative to CMR, which often requires deep sedation and general anesthesia.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1510-1518"},"PeriodicalIF":3.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494457","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":"Impact of Tricuspid Regurgitation From a Population-Based Chronic Heart Failure Registry in Japan - Insights From the KUNIUMI Registry Chronic Cohort.","authors":"Haruna Yokota, Hidekazu Tanaka, Wataru Fujimoto, Tomoyuki Nagano, Susumu Odajima, Makoto Takemoto, Koji Kuroda, Soichiro Yamashita, Junichi Imanishi, Masamichi Iwasaki, Takafumi Todoroki, Masanori Okuda, Akihide Konishi, Masakazu Shinohara, Manabu Nagao, Ryuji Toh, Kunihiro Nishimura, Hiromasa Otake","doi":"10.1253/circj.CJ-24-0991","DOIUrl":"10.1253/circj.CJ-24-0991","url":null,"abstract":"<p><strong>Background: </strong>Although tricuspid regurgitation (TR) is no longer considered a negligible disease, its detailed status in real-world heart failure (HF) patients remains unknown.</p><p><strong>Methods and results: </strong>From the KUNIUMI registry, we evaluated data for 1,646 consecutive HF patients. The primary endpoint was all-cause mortality over a median follow-up period of 3.0 years (interquartile range 1.4-3.0 years). Of the 1,646 HF patients, 369 (22.4%) had moderate or greater TR; the mean (±SD) age of these patients was 82.0±8.5 years. Atrial functional TR was the most common etiology of TR in HF patients with moderate or greater TR (70.7%), and was more common in HF patients with severe than moderate TR (75.5% vs. 65.3%; P=0.032). The mortality rate was high in HF patients with severe and moderate TR (27.1% and 17.0%, respectively). During follow-up, 33.1% of HF patients with moderate TR progressed to severe TR, and showed unfavorable all-cause mortality compared with those with unchanged TR. Atrial functional TR was a more common etiology in HF patients with moderate TR and worsened TR than in those with unchanged TR (84.6% vs. 59.5%; P=0.004). Right atrial enlargement was independently correlated with worsened TR.</p><p><strong>Conclusions: </strong>Moderate or greater TR was prevalent in 22.4% of the real-world super-aged HF population. Even HF patients with moderate TR had poor outcomes, with right atrial remodeling a key factor for worsened TR.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1555-1565"},"PeriodicalIF":3.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059070","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":"Calcific Aortic Valve Disease - From Mechanism to Treatment.","authors":"Yuhe Chen, Songhao Jia, Jiawen Zhang, Jie Han, Hongjia Zhang, Wenjian Jiang","doi":"10.1253/circj.CJ-24-0706","DOIUrl":"10.1253/circj.CJ-24-0706","url":null,"abstract":"<p><p>Calcific aortic valve disease (CAVD) is one of the most prevalent heart valve diseases and is characterized by progressive stiffening and calcification of the aortic valve. For decades, CAVD has been treated with surgical intervention. In recent years, some progress has been made in understanding the pathogenesis of CAVD and the exploration of novel therapeutic strategies, leading to the identification of potential therapeutic targets and innovative treatment approaches. This review systematically outlines the pathophysiological advances in CAVD over the past 5 years, proposing a 3-stage model for disease progression: inflammatory, fibrotic, and calcification stages. In addition, recent clinical trials investigating pharmacological therapies, such as those targeting lipid metabolism, vitamin K pathways, and calcium-phosphorus balance, are summarized and discussed. These developments hold promise for improving patient outcomes and revolutionizing the management of CAVD.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1447-1452"},"PeriodicalIF":3.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081660","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":"Factors Contributing to Hospital-Associated Disability in Elderly Patients After Transcatheter Aortic Valve Implantation.","authors":"Masashi Shimizu, Atsushi Shibata, Kodai Taniguchi, Tomohiro Yamaguchi, Mitsuhiko Ikebuchi, Takanori Yamazaki, Yosuke Takahashi, Terai Hidetomi, Toshihiko Shibata, Daiju Fukuda","doi":"10.1253/circj.CJ-24-0710","DOIUrl":"10.1253/circj.CJ-24-0710","url":null,"abstract":"<p><strong>Background: </strong>Hospital-associated disability (HAD), characterized by a worsening of activities of daily living and physical function following hospitalization, is a common complication in older adults during the course of acute care hospitalization. HAD is a significant concern affecting older adults undergoing transcatheter aortic valve implantation (TAVI).</p><p><strong>Methods and results: </strong>This retrospective study investigated 243 consecutive patients who underwent elective transfemoral TAVI between January 2016 and April 2022. HAD was defined as a decrease of at least 1 point in the Short Physical Performance Battery (SPPB) assessed before discharge compared with before TAVI. Logistic regression identified the first ambulation day after TAVI as an independent predictor of HAD incidence (odds ratio 1.500; 95% confidence interval [CI] 1.115-2.008; P=0.007). Patients with HAD had significantly lower body mass index, hemoglobin, and albumin, and higher serum creatinine. All-cause mortality was significantly higher in patients with than without HAD (log-rank P<0.001). Kaplan-Meier analysis confirmed poorer survival in patients with HAD, regardless of the degree of decline in SPPB. Multivariate Cox analysis regression identified HAD as a predictor of all-cause death (hazard ratio 4.249; 95% CI 1.798-10.04; P<0.001).</p><p><strong>Conclusions: </strong>The timing of the first ambulation was associated with the incidence of HAD. Promoting early mobilization may reduce the risk of HAD after TAVI.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1453-1461"},"PeriodicalIF":3.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051236","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}