Circulation Journal最新文献

{"title":"En-Face View for Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Coronary Artery Obstruction.","authors":"Daisuke Hachinohe, Norio Tada, Ryo Horita, Hidemasa Shitan","doi":"10.1253/circj.CJ-24-0670","DOIUrl":"10.1253/circj.CJ-24-0670","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"2021"},"PeriodicalIF":3.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394962","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":"Five-Year Transcatheter Aortic Valve Replacement Outcomes in Chronic Hemodialysis vs. Non-Hemodialysis Patients Using Balloon-Expandable Devices.","authors":"Isamu Mizote, Daisuke Nakamura, Koichi Maeda, Tomoharu Dohi, Kazuo Shimamura, Ai Kawamura, Kizuku Yamashita, Yutaka Matsuhiro, Shumpei Kosugi, Hiroki Sugae, Yasuharu Takeda, Yasushi Sakata","doi":"10.1253/circj.CJ-24-0050","DOIUrl":"10.1253/circj.CJ-24-0050","url":null,"abstract":"<p><strong>Background: </strong>Based on the results of a clinical trial in Japan, transcatheter aortic valve replacement (TAVR) for hemodialysis (HD) patients gained approval; however, mid-term TAVR outcomes and transcatheter aortic valve (TAV) durability in HD patients remain unexplored.</p><p><strong>Methods and results: </strong>We analyzed background, procedural, in-hospital outcome, and follow-up data for 101 HD patients and 494 non-HD patients who underwent TAVR using balloon-expandable valves (SAPIEN XT or SAPIEN 3) retrieved from Osaka University Hospital TAVR database. Periprocedural mortality and TAVR-related complications were comparable between HD and non-HD patients. However, Kaplan-Meier analysis revealed that HD patients had significantly lower survival rates (log-rank test, P<0.001). In addition, HD patients had significantly higher rates of severe structural valve deterioration (SVD) than non-HD patients (Gray test, P=0.038).</p><p><strong>Conclusions: </strong>TAVR in HD patients had comparable periprocedural mortality but inferior mid-term survival and TAV durability than in non-HD patients. Indications for TAVR in younger HD patients should be carefully determined, considering the possibility of a TAV-in-TAV procedure when early SVD occurs.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1937-1945"},"PeriodicalIF":3.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913372","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":"JCS/JCC/JSPCCS 2024 Guideline on Genetic Testing and Counseling in Cardiovascular Disease.","authors":"Yasushi Imai, Kengo Kusano, Takeshi Aiba, Junya Ako, Yoshihiro Asano, Mariko Harada-Shiba, Masaharu Kataoka, Tomoki Kosho, Toru Kubo, Takayoshi Matsumura, Tetsuo Minamino, Kenji Minatoya, Hiroyuki Morita, Masakazu Nishigaki, Seitaro Nomura, Hitoshi Ogino, Seiko Ohno, Masayuki Takamura, Toshihiro Tanaka, Kenichi Tsujita, Tetsuro Uchida, Hiroyuki Yamagishi, Yusuke Ebana, Kanna Fujita, Kazufumi Ida, Shunsuke Inoue, Kaoru Ito, Yuki Kuramoto, Jun Maeda, Keiji Matsunaga, Reiko Neki, Kenta Sugiura, Hayato Tada, Akihiro Tsuji, Takanobu Yamada, Tomomi Yamaguchi, Eiichiro Yamamoto, Akinori Kimura, Koichiro Kuwahara, Koji Maemura, Tohru Minamino, Hiroko Morisaki, Katsushi Tokunaga","doi":"10.1253/circj.CJ-23-0926","DOIUrl":"10.1253/circj.CJ-23-0926","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"2022-2099"},"PeriodicalIF":3.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331698","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":"Effect of Preoperative Left Ventricular Mass on Outcomes After Aortic Valve Replacement for Aortic Regurgitation.","authors":"Kohei Hachiro, Noriyuki Takashima, Kenichi Kamiya, Yasuo Kondo, Tomoaki Suzuki","doi":"10.1253/circj.CJ-24-0464","DOIUrl":"10.1253/circj.CJ-24-0464","url":null,"abstract":"<p><strong>Background: </strong>We determined the left ventricular mass index (LVMI) cut-off value for the risk of major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing aortic valve replacement (AVR) for aortic regurgitation (AR) and investigated the effect of preoperative left ventricular remodeling on long-term outcomes postoperatively.</p><p><strong>Methods and results: </strong>Of the 1,580 patients who underwent surgical AVR at Shiga University of Medical Science between January 2002 and December 2022, we retrospectively analyzed data for 263 patients who underwent surgery for AR. The receiver operating characteristic curve showed that the cut-off value of preoperative LVMI for the incidence of MACCE was 200 g/m²(area under the curve=0.692). We compared postoperative outcomes between patients with preoperative LVMI >200 g/m²(n=92) and those with preoperative LVMI ≤200 g/m²(n=171) after adjusting for preoperative characteristics using inverse probability of treatment weighting. The mean (±SD) follow-up period was 6.9±5.1 years. The rate of MACCE at 10 years was significantly higher in patients with preoperative LVMI >200 g/m²than in those with preoperative LVMI ≤200 g/m²(25.6% vs. 13.5%; P=0.020). In multivariable Cox models, preoperative LVMI >200 g/m²was significantly associated with a higher risk of MACCE (hazard ratio 2.356, P=0.006).</p><p><strong>Conclusions: </strong>Preoperative LVMI >200 g/m²was associated with a higher rate of MACCE in patients undergoing AVR for AR.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1965-1972"},"PeriodicalIF":3.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479890","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":"Effect of Narrow Chest on Minimally Invasive Mitral Valve Surgery via Right Minithoracotomy.","authors":"Shintaro Sawa, Yoshitsugu Nakamura, Taisuke Nakayama, Miho Kuroda, Kosuke Nakamae, Kusumi Niitsuma, Masaki Ushijima, Yuto Yasumoto, Daiki Yoshiyama, Akira Furutachi, Yujiro Ito, Ryo Tsuruta","doi":"10.1253/circj.CJ-24-0142","DOIUrl":"10.1253/circj.CJ-24-0142","url":null,"abstract":"<p><strong>Background: </strong>The effect of a narrow chest on minimally invasive mitral valve surgery (MIMVS) is unclear.</p><p><strong>Methods and results: </strong>We enrolled 206 MIMVS patients and measured anteroposterior diameter (APD) between the sternum and vertebra, transverse thoracic diameter (TD), right and left APD of the hemithorax (RD and LD, respectively), and the Haller index (HI; TD/APD ratio) on computed tomography. Preoperative characteristics and operative outcomes were compared between patients with a narrow chest (Group N; HI >2.5; n=53) and those with a normal chest (control [C]; HI ≤2.5; n=153), and the correlations of these measurements with operation time were evaluated in 133 patients undergoing an isolated mitral procedure. Groups N and C differed significantly in APD (89.4 vs. 114.3 mm, respectively; P<0.001), TD (251.5 vs. 240.3 mm, respectively; P=0.002), RD (152.5 vs. 172.5 mm, respectively; P<0.001), LD (155.0 vs. 172.4 mm, respectively; P<0.001), and HI (2.84 vs. 2.12, respectively; P<0.001). Procedural characteristics were comparable, except for a longer aortic cross-clamp time (ACCT) in Group N (118.7 vs. 105.8 min; P=0.047). Rates of surgical death, re-exploration, cerebral infarction, and prolonged ventilation were comparable between the 2 groups. TD was significantly correlated with ACCT (R²=0.037, P=0.028) in patients undergoing an isolated mitral procedure.</p><p><strong>Conclusions: </strong>Early MIMVS outcomes in patients with narrow chests are satisfactory. TD prolongs ACCT during MIMVS.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1973-1979"},"PeriodicalIF":3.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176760","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":"Concomitant Mitral Regurgitation in Severe Aortic Stenosis　- Insights From the CURRENT AS Registry-2.","authors":"Yuki Obayashi, Yasuaki Takeji, Tomohiko Taniguchi, Takeshi Morimoto, Shinichi Shirai, Takeshi Kitai, Hiroyuki Tabata, Nobuhisa Ohno, Ryosuke Murai, Kohei Osakada, Koichiro Murata, Masanao Nakai, Hiroshi Tsuneyoshi, Tomohisa Tada, Masashi Amano, Shin Watanabe, Hiroki Shiomi, Hirotoshi Watanabe, Yusuke Yoshikawa, Ryusuke Nishikawa, Ko Yamamoto, Mamoru Toyofuku, Shojiro Tatsushima, Norio Kanamori, Makoto Miyake, Hiroyuki Nakayama, Kazuya Nagao, Masayasu Izuhara, Kenji Nakatsuma, Moriaki Inoko, Takanari Fujita, Masahiro Kimura, Mitsuru Ishii, Shunsuke Usami, Fumiko Nakazeki, Kiyonori Togi, Yasutaka Inuzuka, Kenji Ando, Tatsuhiko Komiya, Koh Ono, Kenji Minatoya, Takeshi Kimura","doi":"10.1253/circj.CJ-24-0103","DOIUrl":"10.1253/circj.CJ-24-0103","url":null,"abstract":"<p><strong>Background: </strong>Data on concomitant mitral regurgitation (MR) in patients with severe aortic stenosis (AS) are scarce.</p><p><strong>Methods and results: </strong>We investigated the risk of concomitant MR in patients with severe AS in the CURRENT AS Registry-2 according to initial treatment strategy (transcatheter aortic valve implantation [TAVI], surgical aortic valve replacement [SAVR], or conservative). Among 3,365 patients with severe AS, 384 (11.4%) had moderate/severe MR (TAVI: n=126/1,148; SAVR: n=68/591; conservative: n=190/1,626). The cumulative 3-year incidence for death or heart failure (HF) hospitalization was significantly higher in the moderate/severe than no/mild MR group in the entire population (54.6% vs. 34.3%, respectively; P<0.001) and for each treatment strategy (TAVI: 45.0% vs. 31.8% [P=0.006]; SAVR: 31.9% vs. 18.7% [P<0.001]; conservative: 67.8% vs. 41.6% [P<0.001]). The higher adjusted risk of moderate/severe MR relative to no/mild MR for death or HF hospitalization was not significant in the entire population (hazard ratio [HR] 1.15; 95% confidence interval [CI] 0.95-1.39; P=0.15); however, the risk was significant in the SAVR (HR 1.92; 95% CI 1.04-3.56; P=0.04) and conservative (HR 1.30; 95% CI 1.02-1.67; P=0.04) groups, but not in the TAVI group (HR 1.03; 95% CI 0.70-1.52; P=0.86), despite no significant interaction (P_interaction=0.37).</p><p><strong>Conclusions: </strong>Moderate/severe MR was associated with a higher risk for death or HF hospitalization in the initial SAVR and conservative strategies, while the association was less pronounced in the initial TAVI strategy.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1996-2007"},"PeriodicalIF":3.1,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892889","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":"Hospitalized Patients, Treatments, and Quality of Care for Cardiovascular Diseases in Japan　- Outline of the Nationwide JROAD Investigation.","authors":"Masahiro Nishi, Yoshihiro Miyamoto, Yoshitaka Iwanaga, Koshiro Kanaoka, Yoko Sumita, Masaharu Ishihara, Maki Katamura, Shun Kohsaka, Masaharu Nakayama, Koichi Node, Yasuko K Bando, Yu Hirao, Keiichi Fukuda, Tetsuya Matoba, Yoshihiro Fukumoto, Satoaki Matoba","doi":"10.1253/circj.CJ-24-0704","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0704","url":null,"abstract":"<p><p>Cardiovascular diseases (CVD) have imposed a substantial burden on population health and society. In Japan, the National Plan for the Promotion of Measures Against Cerebrovascular and Cardiovascular Disease, grounded in national legislation, seeks to improve the quality of care and standardize treatment for cerebrovascular disease and CVD. The plan emphasizes the need to develop standardized systems for collecting and disseminating medical information, as well as promoting data-driven research. The Japanese Registry Of All cardiac and vascular Diseases (JROAD) was launched by the Japanese Circulation Society to assess the clinical activities of institutions nationwide that have a dedicated cardiovascular inpatient service. Information from participating facilities is accumulated, and a database is constructed by linking Diagnosis Procedure Combination data, which includes patient characteristics and clinical data. Using this real-world data is expected to generate high-quality evidence, leading to a better understanding of CVD, improvements in the quality of care and clinical outcomes, and the implementation of effective health policies, including the appropriate allocation of medical resources and the reduction of medical costs. Ultimately, these efforts aim to extend the life span and healthy life expectancy. This design paper outlines the overall concept of the JROAD investigation in cardiovascular care. In addition, it summarizes representative CVD data, reviews the literature on the quality of care, and describes the prospects of the investigation.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683164","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":"Perioperative Management of Takayasu Arteritis for Cardiac Surgery　- Review and Single-Center Experience.","authors":"Yoh Arita, Ryotaro Asano, Jin Ueda, Yoshimasa Seike, Yosuke Inoue, Takeshi Ogo, Satsuki Fukushima, Hitoshi Matsuda, Yoshikazu Nakaoka","doi":"10.1253/circj.CJ-24-0496","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0496","url":null,"abstract":"<p><p>Takayasu arteritis (TAK) is classified as a large vessel vasculitis and often causes vascular stenosis, occlusion, and aneurysm formation. Although the principal treatment for TAK involves suppressing inflammation with glucocorticoids, the emergence of biological disease-modifying antirheumatic drugs has considerably changed the treatment landscape of TAK in recent years. Several biological disease-modifying antirheumatic drugs, such as tocilizumab (TCZ), have shown promising effects on TAK in clinical studies. Cardiologists and cardiovascular surgeons encounter patients receiving these drugs who require catheterization, endovascular treatment, or cardiovascular surgery. However, in patients treated with glucocorticoids and TCZ, there needs to be greater awareness of more complications than usual after surgery, such as delayed wound healing, systemic infection, and surgical site infection. In addition, in patients receiving TCZ, inflammatory markers, such as C-reactive protein, may not increase when complications arise from infection. Unfortunately, there are no guidelines or solid evidence that have clearly defined the optimal perioperative treatment strategy for patients with TAK who require cardiovascular surgery. This article reviews the evidence and our recent experience supporting the perioperative use of TCZ, and proposes a protocol that can reduce complications in patients with TAK undergoing invasive cardiovascular treatment.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631960","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":"Arterial Complications Assessed by Duplex Ultrasound After Decannulation of Peripheral Venoarterial Extracorporeal Membrane Oxygenation.","authors":"Yonghoon Shin, Ki Hong Choi, Taek Kyu Park, Yang Hyun Cho, Jeong Hoon Yang","doi":"10.1253/circj.CJ-24-0400","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0400","url":null,"abstract":"<p><strong>Background: </strong>Vascular complications are common and can be fatal even after successful decannulation in patients with peripherally cannulated veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Therefore, we aimed to accurately determine the incidence of arterial complications assessed by Duplex ultrasound following peripheral VA-ECMO decannulation. In addition, we investigated the predictors of severe complications requiring intervention.</p><p><strong>Methods and results: </strong>We retrospectively reviewed 1,350 adult patients who underwent ECMO between January 2012 and April 2023. Of 839 patients treated with peripherally cannulated VA-ECMO, 596 were successfully weaned off and 212 underwent Duplex ultrasound for final analysis. The primary outcome was arterial complications requiring vascular intervention. Thirty-three (15.6%) patients experienced such complications after decannulation. Acute limb ischemia due to thrombotic occlusion was the most common complication, occurring in 23 (10.8%) patients, followed by stenosis (3.8%), pseudoaneurysm (3.8%), arteriovenous fistula (0.9%), and dissection (0.9%). No significant differences in complication rates were found between the percutaneous and surgical decannulation groups in the propensity score-matched population (12.7% vs. 15.9%, respectively; P=0.799). Multivariable analysis revealed disseminated intravascular coagulation (DIC; odds ratio 2.6; 95% confidence interval 1.17-5.69; P=0.019) as the only predictor of arterial complications after decannulation.</p><p><strong>Conclusions: </strong>Arterial complications requiring vascular intervention frequently occur following successful weaning from VA-ECMO regardless of the decannulation strategy. In this setting, DIC appears to be associated with an increased rate of arterial complications.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631953","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":"Successful Thoracic Endovascular Aortic Repair of Kommerell Diverticulum to Relieve Refractory Chest Oppressions Caused by Secondary Esophageal Stricture.","authors":"Akira Takashima, Eiki Fujimoto, Hiromu Yamazaki","doi":"10.1253/circj.CJ-24-0228","DOIUrl":"10.1253/circj.CJ-24-0228","url":null,"abstract":"","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1862"},"PeriodicalIF":3.1,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156504","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}