{"title":"Predictors of the diuretic response in acute decompensated heart failure patients with severe aortic stenosis: sub-analysis of the LOHAS registry.","authors":"Takuma Takada, Kentaro Jujo, Takuro Abe, Kensuke Shimazaki, Yugo Nara, Hirofumi Hioki, Hideyuki Kawashima, Akihisa Kataoka, Makoto Nakashima, Masanori Yamamoto, Kazuki Mizutani, Masaki Izumo, Gaku Nakazawa, Ken Kozuma, Katsumi Saito, Yusuke Watanabe","doi":"10.1007/s12928-025-01100-1","DOIUrl":"10.1007/s12928-025-01100-1","url":null,"abstract":"<p><p>For severe aortic stenosis (AS) patients awaiting valve replacement, managing acute decompensated heart failure (ADHF) is crucial due to poor prognosis. The LOHAS registry evaluated the effect of tolvaptan in patients (mean age: 85 years) with severe AS and ADHF, demonstrating stable hemodynamics and sufficient diuresis. We investigated predictors of rapid successful decongestion. In the LOHAS study, eligible patients received tolvaptan (7.5 mg) on day 1 plus standard ADHF treatments. Patients were divided based on decongestion achievement on day 4. Of 59 enrolled, 35 (59%) achieved decongestion (decongestion group), and 24 (41%) remained congested (congestion group). Changes in body weight, renal function, and hemodynamics were comparable between groups over the first 4 days. However, the maximum inferior vena cava (IVC) diameter at admission was significantly larger in the decongestion group than the congestion group (12.6 ± 6.3 vs. 7.6 ± 4.8 mm, p = 0.007). ROC analysis revealed a cut-off of 11 mm for maximum IVC diameter to predict decongestion on day 4 (AUC: 0.73, 95% CI 0.58-0.88). In-hospital mortality was lower in the decongestion group (0% vs. 13%, p = 0.06). In conclusion, in this high-risk severe AS and ADHF population, adding tolvaptan to standard therapy may rapidly improve decompensation if patients have a sufficiently expanded IVC at admission. Maximum IVC diameter could predict successful decongestion with tolvaptan.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":"619-628"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Feasibility of optical coherence tomography-guided primary percutaneous coronary intervention for STEMI: all-comer ATLAS-OCT trial.","authors":"Kohei Wakabayashi, Taishi Yonetsu, Takuya Mizukami, Myong Hwa Yamamoto, Sakiko Yasuhara, Koki Shishido, Shigeru Saito, Nobuaki Kobayashi, Masamichi Takano, Eisuke Usui, Tsunekazu Kakuta, Yosuke Oishi, Seita Kondo, Tenjin Nishikura, Yoshiyasu Minami, Junya Ako, Toshitaka Okabe, Toru Naganuma, Satoru Mitomo, Sunao Nakamura, Takumi Higuma, Junya Shite, Amane Kozuki, Satoru Suwa, Teruyoshi Kume, Shiro Uemura, Genki Naruse, Hiroyuki Okura, Yosuke Yamakami, Hiroyuki Fujii, Shigeki Kimura, Masamichi Iwasaki, Makoto Araki, Tomoyo Sugiyama, Mamoru Nanasato, Tomotaka Dohi, Takashi Ashikaga, Hiroyoshi Mori, Teruo Sekimoto, Yoichiro Sugizaki, Hiromasa Otake, Toshiro Shinke","doi":"10.1007/s12928-025-01137-2","DOIUrl":"10.1007/s12928-025-01137-2","url":null,"abstract":"<p><p>Intravascular imaging for acute coronary syndrome is recommended in the guidelines; however, the actual rate of patients with ST-segment elevation myocardial infarction (STEMI) who successfully undergo optical coherence tomography (OCT)-guided primary percutaneous coronary intervention (PCI) is unclear. This study aimed to determine the feasibility of OCT-guided primary PCI and identify the patient population that would benefit most from OCT guidance in STEMI. The ATLAS-OCT trial was a prospective, single-arm, all-comers study conducted at 16 institutions. The primary endpoint was the feasibility of OCT guidance for primary PCI, defined as successful image acquisition (vessel's circumferential or > 270° visualization along > 70% of the lesion's length, as evaluated by an independent core laboratory). A total of 632 patients (mean age: 68.4 years; 80.2% male) were enrolled in the study. OCT-guided PCI was performed in 503 patients, whereas OCT guidance was avoided in 129 patients for patient's condition. Successful image acquisition was achieved in all but seven patients who underwent OCT. The primary endpoint was achieved in 78.5% (496/632) of patients. No procedural complications were associated with OCT. Patients with left main disease (adjusted odds ratio, 4.1; 95% confidence interval, 1.2-14.7; p = 0.024), estimated glomerular filtration rate (mL/min/1.73 m<sup>2</sup>) < 30 (3.7; 1.6-8.3; p = 0.002), and Killip IV (2.5; 1.3-4.6; p = 0.003) were significantly avoided for OCT guidance. OCT guidance was feasible in four-fifths of all-comers with STEMI. Further studies are warranted to evaluate the efficacy of OCT-guided PCI in selected patient populations based on the findings of this trial (UMIN000048590).</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":"576-587"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Serial morphological and functional changes following intensive pharmacological intervention for left main disease.","authors":"Takayuki Warisawa, Susumu Katsushika, Yoshiki Kawai, Jiro Ando","doi":"10.1007/s12928-025-01102-z","DOIUrl":"10.1007/s12928-025-01102-z","url":null,"abstract":"","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":"703-704"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tetsuo Yamaguchi, Harindra C Wijeysundera, Sam Radhakrishnan
{"title":"Efficacy of cerebral embolic protection device in high-risk transcatheter aortic valve implantation.","authors":"Tetsuo Yamaguchi, Harindra C Wijeysundera, Sam Radhakrishnan","doi":"10.1007/s12928-025-01117-6","DOIUrl":"10.1007/s12928-025-01117-6","url":null,"abstract":"","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":"717-718"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Feasibility and safety of the distal radial access for vascular access interventional therapy.","authors":"Koji Kuroda, Ayaka Murakami, Takafumi Todoroki, Masamichi Iwasaki, Junichi Imanishi, Souichiro Yamashita, Wataru Fujimoto, Makoto Takemoto, Masanori Okuda","doi":"10.1007/s12928-025-01127-4","DOIUrl":"10.1007/s12928-025-01127-4","url":null,"abstract":"<p><p>Distal radial access (DRA) has emerged as an alternative approach to reduce the risk of radial artery occlusion in coronary angiography. Vascular access intervention therapy (VAIVT) is traditionally used to treat arteriovenous fistula stenosis. However, the feasibility and safety of DRA for VAIVT have not been established. This study aimed to evaluate the feasibility and safety of using DRA for VAIVT. We included 421 consecutive VAIVT procedures for upper limb arteriovenous fistulas retrospectively. DRA for VAIVT was performed in 181 procedures (DRA group), and the remaining procedures were approached through the brachial artery or vein (SA group: standard access group). Clinical follow-up was performed to evaluate the incidence of hematoma and dialysis access-associated steal syndrome (DASS). The mean follow-up duration following VAIVT was 24.0 months. The VAIVT success rate did not differ significantly between the groups (DRA: 97.8% vs. SA: 98.3%; P = 0.73), neither did the incidence of puncture site hematoma (DRA: 0.0% vs. SA: 0.8%; P = 0.51). There were no complications with DASS symptoms in the DRA group during the clinical follow-up. In the DRA group, 90 patients underwent a subsequent VAIVT procedure, and 85 patients (94.4%) underwent a subsequent VAIVT by DRA. DRA is a feasible and safe strategy for VAIVT and could be considered an option for VAIVT.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":"599-606"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989914","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":"Insights into balloon pulmonary angioplasty and the WHO functional class of chronic thromboembolic pulmonary hypertension patients: findings from the CTEPH AC registry.","authors":"Nobutaka Ikeda, Kohei Masaki, Kazuya Hosokawa, Kouta Funakoshi, Yu Taniguchi, Shiro Adachi, Takumi Inami, Jun Yamashita, Hitoshi Ogino, Ichizo Tsujino, Masaru Hatano, Nobuhiro Yaoita, Hiroto Shimokawahara, Nobuhiro Tanabe, Kayoko Kubota, Ayako Shigeta, Yoshito Ogihara, Koshin Horimoto, Yoshihiro Dohi, Takashi Kawakami, Yuichi Tamura, Koichiro Tatsumi, Kohtaro Abe","doi":"10.1007/s12928-025-01095-9","DOIUrl":"10.1007/s12928-025-01095-9","url":null,"abstract":"<p><p>Advances in chronic thromboembolic pulmonary hypertension (CTEPH) treatment have improved prognosis, shifting focus towards symptom management. This study aimed to identify factors influencing the World Health Organization functional class (WHO-FC) in CTEPH patients. The CTEPH AC registry is a prospective, multicenter database from 35 Japanese institutions, analyzing data from August 2018 to July 2023. We examined factors associated with achieving WHO-FC I and WHO-FC changes over time in 1,270 patients. Significant factors for WHO-FC I achievement included male sex (odds ratio: 1.86, p = 0.019), age (0.98, p = 0.007), pulmonary vasodilator use (0.51, p = 0.001), post-balloon pulmonary angioplasty (BPA) (1.93, p = 0.010), lower mean pulmonary arterial pressure (0.94, p = 0.004), and lower pulmonary vascular resistance (PVR) (0.78, p = 0.006). Multivariate analysis showed that WHO-FC improvement correlated with male sex, baseline PVR, and BPA during follow-up. WHO-FC deterioration was associated with cancer, history of pulmonary endarterectomy and/or BPA at registration, bleeding risks, and thyroid disease or hormone therapy. BPA implementation is closely linked to symptomatic improvement and achieving WHO-FC I, while symptom worsening is often associated with patient-specific, difficult-to-control conditions.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":"689-700"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}