{"title":"Early Changes in Left Ventricular Myocardial Mechanics After Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis.","authors":"Takeru Ikenaga, Yuta Kato, Yuto Kawahira, Midori Miyazaki, Tetsuo Hirata, Hiromitsu Teratani, Go Kuwahara, Makoto Sugihara, Hideichi Wada, Masahiro Ogawa, Shin-Ichiro Miura","doi":"10.1253/circrep.CR-24-0139","DOIUrl":"https://doi.org/10.1253/circrep.CR-24-0139","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) improves left ventricular (LV) deformation by aortic stenosis (AS). However, the early effects of TAVR on LV mechanics as assessed by echocardiography have not been fully elucidated.</p><p><strong>Methods and results: </strong>Between 2021 and 2024, we included 81 patients who underwent transfemoral TAVR for severe AS. We used the natural logarithm of B-type natriuretic peptide (lnBNP) 1 week after TAVR as an indicator of the early effects on LV mechanics. To determine the association with echocardiographic parameters (LV ejection fraction [LVEF], global longitudinal strain [GLS], E/e', and Tei index) and postprocedural lnBNP, we used regression models while adjusting for covariates. There were no significant differences in LVEF, GLS or E/e' between before and after TAVR, but the postprocedural Tei index was significantly higher than the preprocedural Tei index (0.40 vs. 0.26, P<0.01). In a univariate linear regression, the preprocedural LVEF (β=-0.28, P=0.01), GLS (β=-0.24, P=0.04), E/e' (β=0.36, P<0.01), and Tei index (β=0.27, P=0.02) correlated with postprocedural lnBNP. Regarding the postprocedural parameters, GLS (β=-0.27, P=0.02) and E/e' (β=0.36, P<0.01) also correlated with postprocedural lnBNP, but the LVEF and Tei index did not. After adjustment for covariates, these correlations remained significant.</p><p><strong>Conclusions: </strong>Preprocedural echocardiographic parameters reflecting LV function correlated with BNP after TAVR, but the utility of postprocedural parameters may depend on preprocedural LV function or perioperative factors.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 5","pages":"365-371"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Angiogenesis Using Recombinant Basic Fibroblast Growth Factor With Atelocollagen in Normal and Hind Limb Ischemia Models.","authors":"Atsushi Kotani, Shin Watanabe, Takao Kato, Takayuki Kikuchi, Keiji Toya, Katsuhiko Hori, Noriko Minobe, Kaori Musumi, Yasuko Kimura, Yoji Nagai, Jun Yoshimura, Hirofumi Kawamata, Kenji Yanishi, Satoaki Matoba","doi":"10.1253/circrep.CR-25-0011","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0011","url":null,"abstract":"<p><strong>Background: </strong>Basic fibroblast growth factor (bFGF) is an angiogenic factor with a short half-life. Because recombinant bFGF is in clinical use, we hypothesized that the localization of recombinant bFGF with atelocollagen would have angiogenic effects at the injection site in normal and hind limb ischemic animal models.</p><p><strong>Methods and results: </strong>We administered the recombinant bFGF with atelocollagen intramuscularly to hind limbs in normal rabbits or in a mouse model of femoral artery ligation to explore the pharmacological action for ischemia. We evaluated blood flow in the ischemic/normal limb using laser speckle perfusion imaging and the density of blood vessels by pathological examination. At the administration site in normal rabbits, a significant increase in the number of blood vessels was noted at 14 days post-administration of recombinant bFGF with atelocollagen compared with saline or atelocollagen alone. In mice with femoral artery ligation, blood flow and vessels in the ischemic hind limb increased at 2 weeks after injection and more at 4 weeks after injection, and the effect was most significant in mice administered 100 μg of recombinant bFGF with 3% of atelocollagen.</p><p><strong>Conclusions: </strong>Intramuscular administration of recombinant bFGF with atelocollagen induced angiogenesis between 2 and 4 weeks in both normal and ischemic hind limbs.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 5","pages":"372-378"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Promoting Diversity in Cardiac Rehabilitation Programs at Community Hospitals.","authors":"Noriko Fukue, Masakazu Miura, Ikki Tokumoto, Yuka Hajima, Sanae Namba, Shinya Kohtoku, Yasuhiro Ikeda","doi":"10.1253/circrep.CR-25-0017","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0017","url":null,"abstract":"<p><strong>Background: </strong>Although comprehensive cardiac rehabilitation (CR) is an effective treatment for cardiovascular diseases, its implementation in Japan remains insufficient. Following the 2022 Basic Act on Cardiovascular Disease Prevention, each prefecture has established specific targets.</p><p><strong>Methods and results: </strong>We report our experience implementing and managing CR programs across hospitals of different sizes in Yamaguchi Prefecture, Japan, including Tokuyama Medical Association Hospital (initiated in 2019), Mitajiri Hospital (initiated in 2022), and Yamaguchi Prefectural Grand Medical Center. Hospital size and functionality correlated with the diversity and number of healthcare professionals available to provide CR services. In mixed-care hospitals, both inpatient and outpatient CR participants were older compared with acute-care hospitals. Insurance reimbursement calculations and bed-type restrictions affected CR service delivery. The CR team exemplifies interprofessional collaboration in cardiovascular care.</p><p><strong>Conclusions: </strong>Even without all the necessary professional roles, patients can benefit significantly from CR implemented using available resources. Building effective organizations requires embracing diversity and enabling each profession to demonstrate its expertise while ensuring the psychological safety of team members.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 4","pages":"219-222"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The First Experience of Transjugular Transcatheter Tricuspid Valve Replacement With LuX-Valve Plus System in Japan.","authors":"Ryo Horita, Daisuke Hachinohe, Ryo Otake, Shah Sagar, Hidemasa Shitan, Kazuki Mizutani","doi":"10.1253/circrep.CR-25-0020","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0020","url":null,"abstract":"","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 5","pages":"393-394"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Triphasic Changes in Ischemic Stroke Incidence With Age in Non-Valvular Atrial Fibrillation Patients - Pooled Analysis of the Shinken Database, J-RHYTHM Registry, and Fushimi AF Registry.","authors":"Shinya Suzuki, Takeshi Yamashita, Ken Okumura, Hirotsugu Atarashi, Masaharu Akao, Hiroshi Inoue","doi":"10.1253/circrep.CR-25-0009","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0009","url":null,"abstract":"<p><strong>Background: </strong>The basis for the specific age threshold for increasing of ischemic stroke in non-valvular atrial fibrillation (NVAF) patients has not been fully evaluated.</p><p><strong>Methods and results: </strong>We conducted a pooled analysis of 3,588 Japanese NVAF patients without anticoagulation therapy from the Shinken Database (n=1,099), the J-RHYTHM Registry (n=1,002), and the Fushimi AF Registry (n=1,487) to determine the incidence of ischemic stroke by age group; patients aged between 31 and 90 years (n=3,455) were analyzed. During a follow-up period of 1.47 years, 69 ischemic strokes occurred (1.33% per year). The incidence of ischemic stroke exhibited triphasic changes as follows: first, it ranged from 0.00% per year to 0.41% per year across the age groups between 31-35 and 46-50 years. Second, it then rose to 1.58% per year in the 56-60-years age group, remaining around 1% per year across the age groups between 56-60 and 71-75 years, with rates ranging from 0.83% to 1.58% per year. Last, it further increased to 2.35% per year in the 76-80-year age group, remaining around 2.5% per year across the age groups between 76-80 and 86-90 years.</p><p><strong>Conclusions: </strong>The incidence of ischemic stroke in NVAF patients exhibits triphasic changes with age, with notable increases observed in patients aged in their late 50s and late 70s.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 4","pages":"303-307"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Associations Between Mean Arterial Pressure and Prognosis in Acute Myocardial Infarction Complicated by Cardiogenic Shock Differ Depending on Coma Status.","authors":"Keishi Moriwaki, Tairo Kurita, Kazuma Yamaguchi, Kenta Uno, Yumi Hirota, Masashi Yanagisawa, Ryo Okado, Hiromasa Ito, Takashi Kato, Shusuke Fukuoka, Akihiro Takasaki, Kentaro Kakuta, Naoki Fujimoto, Takashi Yamanaka, Ryuji Okamoto, Kaoru Dohi","doi":"10.1253/circrep.CR-25-0001","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0001","url":null,"abstract":"<p><strong>Background: </strong>In acute myocardial infarction complicated by cardiogenic shock (AMI-CS), low mean arterial pressure (MAP) can reduce cerebral perfusion, potentially resulting in coma. While both MAP and coma on admission are critical prognostic factors, the relationship between them and their prognostic significance based on coma status remains unclear.</p><p><strong>Methods and results: </strong>A retrospective analysis of 543 AMI-CS patients was conducted. The overall median MAP was 77 mmHg, with no significant difference between the coma and non-coma groups. The coma group had a higher 30-day mortality compared with the non-coma group (50% vs. 29%; P<0.001). The area under the curve for MAP predicting 30-day mortality was 0.723 (P<0.001) in the coma group, with a cut-off MAP of 76.3 mmHg (sensitivity 0.66, specificity 0.69), but was insignificant in the non-coma group (AUC 0.543; P=0.176). Kaplan-Meier analysis showed higher mortality with low MAP (<77 mmHg) in the coma group, whereas MAP had no significant impact in the non-coma group. Multivariate Cox regression identified low MAP as an independent prognostic factor in the coma group only.</p><p><strong>Conclusions: </strong>The associations between MAP and prognosis differ depending on the coma status in AMI-CS. Low MAP is a prognostic factor for mortality only in patients with coma. This study highlights the need for treatment strategies tailored to neurological status.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 4","pages":"247-256"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Randomised Crossover Trial of Home-Based Neuromuscular Electrical Stimulation Therapy as an Adjunct to Cardiac Rehabilitation in Frail Older Adult Patients With Chronic Heart Failure.","authors":"Shintaro Ono, Michitaka Kato, Hiromasa Seko, Eiji Nakatani, Toshiya Omote, Mayuko Omote, Shingo Omote","doi":"10.1253/circrep.CR-24-0091","DOIUrl":"https://doi.org/10.1253/circrep.CR-24-0091","url":null,"abstract":"<p><strong>Background: </strong>Neuromuscular electrical stimulation (NMES) is an alternative therapy for patients unable to perform sufficient voluntary exercises. This randomised crossover study aimed to evaluate the safety and efficacy of home-based NMES as an adjunct to cardiac rehabilitation (CR) for improving physical function in frail older adult patients with chronic heart failure (CHF).</p><p><strong>Methods and results: </strong>8 frail older adult patients with CHF underwent 8 weeks of CR supplemented with home-based NMES and 8 weeks of CR alone in random order, separated with a 4-week washout period. NMES at 50-Hz frequency was administered for 50 min/day, 5 times per week, with electrodes placed on the legs. Changes in the short physical performance battery (SPPB) score, leg strength, and the Barthel index were assessed between patients with CR with and without home-based NMES. No NMES-related adverse events were observed. CR with home-based NMES had a higher total SPPB score and 5-repetition sit-to-stand test time of 2.67 points and -10.67 s, respectively, than CR alone (95% confidence interval [CI] 0.3-5.0, P<0.05 and 95% CI -19.5 to -1.3, P<0.05, respectively). No significant leg strength or Barthel index changes were observed between CR with and without home-based NMES.</p><p><strong>Conclusions: </strong>Home-based NMES safely improved physical function in frail older adult patients with CHF.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 4","pages":"231-238"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy and Safety of Sodium-Glucose Cotransporter 2 Inhibitors for Patients With Heart Failure and Low Body Mass Index.","authors":"Miyu Hatamura, Shuhei Tsuji, Junichi Tazaki, Mamoru Toyofuku","doi":"10.1253/circrep.CR-25-0008","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0008","url":null,"abstract":"<p><strong>Background: </strong>Previous reports have shown that sodium-glucose cotransporter 2 inhibitors (SGLT2i) benefit patients with heart failure (HF), regardless of left ventricular ejection fraction. However, evidence is limited for patients who are underweight, particularly with a body mass index (BMI) <20 kg/m<sup>2</sup>.</p><p><strong>Methods and results: </strong>Between February 2022 and July 2023, 533 patients were hospitalized at the Japanese Red Cross Wakayama Medical Center for acute HF. Excluding those who died during hospitalization, we categorized 488 patients according to their BMI at discharge: <20 kg/m<sup>2</sup> (n=201), and ≥20 kg/m<sup>2</sup> (n=287). Among the BMI <20 kg/m<sup>2</sup> group, SGLT2i was prescribed to 53 patients. The cumulative incidence rates of all-cause mortality at 1 year were significantly different between BMI <20 kg/m<sup>2</sup> patients with and without SGLT2i (11.8% vs. 36.1%; log-rank P=0.004). In the multivariate Cox proportional hazard models, SGLT2i reduced the risk of all-cause mortality independent of age, frailty, walking speed, decreased albumin level, elevated C-reactive protein level, and prescriptions of renin-angiotensin-aldosterone system inhibitors and mineralocorticoid receptor antagonists. However, among patients who received SGLT2i, the SGLT2i prescription continuation rate at 1 year was not significantly different between the BMI <20 kg/m<sup>2</sup> and BMI ≥20 kg/m<sup>2</sup> groups (85.4% vs. 84.6%; log-rank P=0.869).</p><p><strong>Conclusions: </strong>SGLT2i are feasibly effective and well-tolerated drugs, even for patients with low BMI.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 5","pages":"323-330"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Multivessel Disease and Left Ventricular Dysfunction.","authors":"Ko Yamamoto, Hiroki Shiomi, Ryusuke Nishikawa, Takeshi Morimoto, Akiyoshi Miyazawa, Toru Naganuma, Satoru Suwa, Takanari Fujita, Takenori Domei, Shojiro Tatsushima, Akihiro Takasaki, Akihiro Kikuchi, Atsunori Okamura, Nobuhiro Suematsu, Tsuyoshi Isawa, Shintaro Honda, Yoshiaki Kawase, Kazushige Kadota, Kenji Ando, Kiyoshi Hibi, Koh Ono, Takeshi Kimura","doi":"10.1253/circrep.CR-25-0005","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0005","url":null,"abstract":"<p><strong>Background: </strong>Data on clinical outcomes after intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with multivessel disease and left ventricular (LV) dysfunction are scarce.</p><p><strong>Methods and results: </strong>The OPTIVUS-Complex PCI study multivessel cohort was a prospective multicenter single-arm trial enrolling 1,010 patients undergoing multivessel IVUS-guided PCI including left anterior descending coronary artery target with an intention to meet the prespecified OPTIVUS criteria for optimal stent expansion. We compared clinical outcomes between patients with and without LV dysfunction. The primary endpoint was a composite of death, myocardial infarction, stroke, any coronary revascularization, or hospitalization for heart failure. There were 763 patients (75.5%) with preserved LV function (LV ejection fraction [LVEF] >50%), 176 patients (17.4%) with moderate LV dysfunction (35<LVEF≤50%), and 71 patients (7.0%) with severe LV dysfunction (LVEF ≤35%). The cumulative 1-year incidence of the primary endpoint was 9.5%, 18.9%, and 17.1%, respectively, in patients with preserved LV function, moderate LV dysfunction, and severe LV dysfunction (log-rank P<0.001). After adjusting confounders, there was a significantly higher risk of moderate LV dysfunction and a numerically higher risk of severe LV dysfunction relative to preserved LV function for the primary endpoint (hazard ratio (HR), 1.71; 95% confidence interval (CI), 1.08-2.71; P=0.02; and HR, 1.52; 95% CI, 0.77-2.97; P=0.23).</p><p><strong>Conclusions: </strong>Among patients undergoing multivessel IVUS-guided PCI with contemporary practice, 1-year clinical outcomes were worse in patients with LV dysfunction.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 4","pages":"275-284"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}