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Article ; Online: Rethinking appropriate blanking period after atrial fibrillation ablation.

Onishi, Naoaki / Suenaga, Akihira / Yoshida, Akinori / Kobayashi, Takayasu / Kyo, Shokan / Oi, Maki / Higashitani, Nobuya / Nakazeki, Fumiko / Oyamada, Naofumi / Jinnai, Toshikazu / Kaitani, Kazuaki

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

2024

Abstract: Background: Early recurrence (ER) within a 90-day blanking period (BP) in catheter ablation (CA) for atrial fibrillation (AF) is a risk factor for late recurrence (LR) after 90 days postoperatively. However, few reports have examined them in the second ... ...

Abstract	Background: Early recurrence (ER) within a 90-day blanking period (BP) in catheter ablation (CA) for atrial fibrillation (AF) is a risk factor for late recurrence (LR) after 90 days postoperatively. However, few reports have examined them in the second CA and compared them to the first CA. Moreover, in recent years, there have been reports suggesting that BP should be reduced from 90 to 30 days. Therefore, the association between ER and LR in the first and the second CA was examined, and the validity of a 30-day BP was evaluated. Methods: A total of 511 consecutive patients undergoing the first CA and 116 of these patients undergoing the second CA for AF at a single institution from November 2016 to December 2020 were analyzed retrospectively. Results: When ER within a 90-day BP was divided into 0-30 days and 31-90 days according to the timing of the last ER episode, the hazard ratios on LR of them relative to no ER were 2.7 {95% confidence interval (CI) 1.7-4.2} and 9.7 (95% CI 6.6-14.3), respectively, for the first CA and 15.3 (95% CI 4.7-50.1) and 44.1 (95% CI 14.0-139.4), respectively, for the second CA. Conclusions: ER was strongly associated with LR, especially in patients with the last episode of ER more than 30 days after CA. This was pronounced in cases after the second CA, when PVI appeared to be completed. With the current improvement in PVI durability, BP may be acceptable for 30 days.
Language	English
Publishing date	2024-02-16
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1329179-8
ISSN	1572-8595 ; 1383-875X
ISSN (online)	1572-8595
ISSN	1383-875X
DOI	10.1007/s10840-024-01754-6
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Zs.A 5214: Show issues

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Article ; Online: Reinforcement of the anchor balloon system in percutaneous coronary intervention: an in vitro assessment.

Higami, Hirooki / Nomura, Shinnosuke / Higashitani, Nobuya / Jinnai, Toshikazu / Kaitani, Kazuaki

Cardiovascular intervention and therapeutics

2020 Volume 36, Issue 2, Page(s) 219–225

Abstract: We evaluated the factors that increase the maximum static friction force between the anchoring balloon and the vessel wall. The anchor technique in percutaneous coronary intervention (PCI) may be better supported by a guiding catheter. However, in some ... ...

Abstract	We evaluated the factors that increase the maximum static friction force between the anchoring balloon and the vessel wall. The anchor technique in percutaneous coronary intervention (PCI) may be better supported by a guiding catheter. However, in some cases, the anchor balloon does not perform optimally due to slippage within the anchoring vessel. Furthermore, the optimal procedure for balloon anchoring remains unknown. We evaluated the maximum static friction force of the anchor balloon via in vitro assessments using a simulated vessel model and coronary balloons. The simulated vessel model was composed of polytetrafluoroethylene, and its inner diameter was 1.5 mm. The various-sized balloons (diameter: 1.5 mm, 1.75 mm, and 2.0 mm; length: 10 mm and 15 mm) were inflated within the simulated vessel at various atmospheres. The maximum static friction force was measured by pulling on the balloon catheter shaft using 10-g weights. We performed the same experiment with a jailing 0.014″ wire under the anchoring balloon. Evaluated wires included a silicon coating coil wire, hydrophilic coating coil wire, polymer-coated non-tapering wire, and polymer-coated tapered wire. The maximum static friction force between the anchoring balloon and the simulated vessel increased with an increase in inflation pressure and balloon length. However, increasing the balloon diameter was not effective. The jailing 0.014″ wire, particularly coil wire, was effective in increasing the maximum static friction force of the anchor balloon. A longer balloon, higher inflation pressure, and jailing coil wire could reinforce the anchor balloon system.
MeSH term(s)	Angioplasty, Balloon, Coronary/instrumentation ; Coronary Artery Disease/diagnosis ; Coronary Artery Disease/surgery ; Equipment Design ; Humans ; Percutaneous Coronary Intervention/methods ; Reproducibility of Results
Language	English
Publishing date	2020-05-19
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2581654-8
ISSN	1868-4297 ; 1868-4300
ISSN (online)	1868-4297
ISSN	1868-4300
DOI	10.1007/s12928-020-00674-2
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Zs.A 4771: Show issues

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Article ; Online: Fulminant myocarditis with complete atrioventricular block after mRNA COVID-19 vaccination: A case report.

Onishi, Naoaki / Konishi, Yuki / Kaneko, Toshiyuki / Maekawa, Naohiro / Suenaga, Akihira / Nomura, Shinnosuke / Kobayashi, Takayasu / Kyo, Shokan / Okabayashi, Marie / Higami, Hirooki / Oi, Maki / Higashitani, Nobuya / Saijo, Sayaka / Nakazeki, Fumiko / Oyamada, Naofumi / Jinnai, Toshikazu / Okuno, Tomoko / Shirase, Tomoyuki / Kaitani, Kazuaki

Journal of cardiology cases

2023 Volume 27, Issue 5, Page(s) 229–232

Abstract: A 71-year-old man was transferred urgently to our hospital after collapsing near his home post the first shot of the BNT162b2 coronavirus disease 2019 vaccine (Pfizer-BioNTech, Comirnaty®). Immediately after arrival at our hospital, cardiac arrest due to ...

Abstract	A 71-year-old man was transferred urgently to our hospital after collapsing near his home post the first shot of the BNT162b2 coronavirus disease 2019 vaccine (Pfizer-BioNTech, Comirnaty®). Immediately after arrival at our hospital, cardiac arrest due to complete atrioventricular block with no ventricular escaped beats was observed on electrocardiogram. Echocardiography showed preserved left ventricular ejection fraction, however, diffuse severe hypokinesia was revealed after 3 weeks, and he died 3 months after admission because of worsening heart failure. An autopsy examination revealed eosinophilic myocarditis or hypersensitivity myocarditis with extensive fibrosis and widespread myocardial dropout throughout the heart. Learning objective: 1. Severe myocarditis occurs extremely rarely after mRNA coronavirus disease 2019 (COVID-19) vaccination. 2. Myocarditis after mRNA COVID-19 vaccination might cause complete atrioventricular block, followed by a course of decreased left ventricular ejection fraction. 3. Histologically, severe myocarditis after mRNA COVID-19 vaccination seems to present as fulminant necrotizing eosinophilic myocarditis or hypersensitivity myocarditis.
Language	English
Publishing date	2023-01-27
Publishing country	Japan
Document type	Case Reports
ISSN	1878-5409
ISSN (online)	1878-5409
DOI	10.1016/j.jccase.2023.01.004
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Article: Rate-dependent and unidirectional conduction block between the left pulmonary vein and left atrium after catheter ablation for atrial fibrillation.

Oi, Maki / Nomura, Shinnosuke / Miho, Mitsunori / Kobayashi, Takayasu / Okabayashi, Marie / Higami, Hirooki / Onishi, Naoaki / Higashitani, Nobuya / Saijo, Sayaka / Nakazeki, Fumiko / Oyamada, Naofumi / Jinnai, Toshikazu / Terada, Shohei / Osaki, Shota / Horii, Katsutoshi / Kaitani, Kazuaki

Journal of arrhythmia

2020 Volume 36, Issue 6, Page(s) 1096–1099

Abstract: A 77-year-old woman with symptomatic paroxysmal atrial fibrillation (PAF) underwent pulmonary vein isolation (PVI), but subsequently experienced recurrence. In the second session, unidirectional left atrium (LA)-left superior pulmonary vein (LSPV) ... ...

Abstract	A 77-year-old woman with symptomatic paroxysmal atrial fibrillation (PAF) underwent pulmonary vein isolation (PVI), but subsequently experienced recurrence. In the second session, unidirectional left atrium (LA)-left superior pulmonary vein (LSPV) conduction was revealed to exist at the carina of the LSPV. Left pulmonary vein (LPV) pacing performed in a cycle between 300 and 260 ms revealed rate-dependent pulmonary vein (PV)-LA conduction, and the location was estimated to be in the roof of the LSPV. PV isolation was achieved after ablation of two gaps. Consideration of the presence of rate-dependent gaps may be useful to confirm bidirectional block lines after ablation.
Language	English
Publishing date	2020-09-10
Publishing country	Japan
Document type	Case Reports
ZDB-ID	2696593-8
ISSN	1883-2148 ; 1880-4276
ISSN (online)	1883-2148
ISSN	1880-4276
DOI	10.1002/joa3.12425
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Article: Improvement in quality of life and cardiac function after catheter ablation for asymptomatic persistent atrial fibrillation.

Onishi, Naoaki / Kyo, Shokan / Oi, Maki / Jinnai, Toshikazu / Kuroda, Maiko / Shimizu, Yukiko / Imamura, Sari / Harita, Takeshi / Nishiuchi, Suguru / Hanazawa, Koji / Tamura, Toshihiro / Izumi, Chisato / Nakagawa, Yoshihisa / Kaitani, Kazuaki

Journal of arrhythmia

2020 Volume 37, Issue 1, Page(s) 11–19

Abstract: Background: Catheter ablation (CA) for atrial fibrillation (AF) is widely performed. However, the indication for CA in patients with asymptomatic persistent AF is still controversial.: Methods: Among 259 consecutive patients who were hospitalized for ...

Abstract	Background: Catheter ablation (CA) for atrial fibrillation (AF) is widely performed. However, the indication for CA in patients with asymptomatic persistent AF is still controversial. Methods: Among 259 consecutive patients who were hospitalized for initial CA of AF, a total of 45 patients who had asymptomatic persistent AF were retrospectively analyzed. Quality of life (QOL) before and 1 year after CA was evaluated, and changes in the cardiac function over 5 years after CA were also examined. QOL was assessed using the AF QOL questionnaire (AFQLQ) developed by the Japanese Heart Rhythm Society. In addition, cardiac function was assessed by measuring the plasma B-type natriuretic peptide (BNP) level, left ventricular ejection fraction (LVEF), left atrial diameter (LAD) with transthoracic echocardiogram, and left atrial (LA) volume with computed tomography (CT). Results: The AFQLQ significantly improved after CA in terms of "symptom frequency" and "activity limits and mental anxiety." The plasma BNP level, LVEF, and LAD significantly improved in the first 3 months after the first CA, with no significant changes thereafter (from 149.0 pg/dL [95% confidence intervals {CI}, 114.5-183.5 pg/dL] to 49.8 pg/dL [95% CI, 26.5-70.1], Conclusion: Improvement in the QOL and cardiac function after CA of asymptomatic persistent AF was revealed. Asymptomatic persistent AF should be appropriately treated by CA.
Language	English
Publishing date	2020-12-11
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2696593-8
ISSN	1883-2148 ; 1880-4276
ISSN (online)	1883-2148
ISSN	1880-4276
DOI	10.1002/joa3.12457
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Article ; Online: Tricuspid regurgitation in elderly patients with acute heart failure: insights from the KCHF registry.

Obayashi, Yuki / Kato, Takao / Yaku, Hidenori / Morimoto, Takeshi / Seko, Yuta / Inuzuka, Yasutaka / Tamaki, Yodo / Yamamoto, Erika / Yoshikawa, Yusuke / Kitai, Takeshi / Taniguchi, Ryoji / Iguchi, Moritake / Kato, Masashi / Takahashi, Mamoru / Jinnai, Toshikazu / Ikeda, Tomoyuki / Nagao, Kazuya / Kawai, Takafumi / Komasa, Akihiro /

Nishikawa, Ryusuke / Kawase, Yuichi / Morinaga, Takashi / Su, Kanae / Kawato, Mitsunori / Inoko, Moriaki / Toyofuku, Mamoru / Furukawa, Yutaka / Nakagawa, Yoshihisa / Ando, Kenji / Kadota, Kazushige / Shizuta, Satoshi / Ono, Koh / Sato, Yukihito / Kuwahara, Koichiro / Ozasa, Neiko / Kimura, Takeshi

ESC heart failure

2023 Volume 10, Issue 3, Page(s) 1948–1960

Abstract: Aims: Several studies demonstrated that tricuspid regurgitation (TR) is associated with poor clinical outcomes. However, data on patients with TR who experienced acute heart failure (AHF) remains scarce. The purpose of this study is to evaluate the ... ...

Abstract	Aims: Several studies demonstrated that tricuspid regurgitation (TR) is associated with poor clinical outcomes. However, data on patients with TR who experienced acute heart failure (AHF) remains scarce. The purpose of this study is to evaluate the association between TR and clinical outcomes in patients admitted with AHF, using a large-scale Japanese AHF registry. Methods and results: The current study population consisted of 3735 hospitalized patients due to AHF in the Kyoto Congestive Heart Failure (KCHF) registry. TR grades were assessed according to the routine clinical practice at each participating centre. We compared the baseline characteristics and outcomes according to the severity of TR. The primary outcome was all-cause death. The secondary outcome was hospitalization for heart failure (HF). The median age of the entire study population was 80 (interquartile range: 72-86) years. One thousand two hundred five patients (32.3%) had no TR, while mild, moderate, and severe TR was found in 1537 patients (41.2%), 776 patients (20.8%), and 217 patients (5.8%), respectively. Pulmonary hypertension, significant mitral regurgitation, and atrial fibrillation/flutter were strongly associated with the development of moderate/severe of TR, while left ventricular ejection fraction <50% was inversely associated with it. Among 993 patients with moderate/severe TR, the number of patients who underwent surgical intervention for TR within 1 year was only 13 (1.3%). The median follow-up duration was 475 (interquartile range: 365-653) days with 94.0% follow-up at 1 year. As the TR severity increased, the cumulative 1 year incidence of all-cause death and HF admission proportionally increased ([14.8%, 20.3%, 23.4%, 27.0%] and [18.9%, 23.0%, 28.5%, 28.4%] in no, mild, moderate, and severe TR, respectively). Compared with no TR, the adjusted risks of patients with mild, moderate, and severe TR were significant for all-cause death (hazard ratio [95% confidence interval]: 1.20 [1.00-1.43], P = 0.0498, 1.32 [1.07-1.62], P = 0.009, and 1.35 [1.00-1.83], P = 0.049, respectively), while those were not significant for hospitalization for HF (hazard ratio [95% confidence interval]: 1.16 [0.97-1.38], P = 0.10, 1.19 [0.96-1.46], P = 0.11, and 1.20 [0.87-1.65], P = 0.27, respectively). The higher adjusted HRs of all the TR grades relative to no TR were significant for all-cause death in patients aged <80 years, but not in patients aged ≥80 years with significant interaction. Conclusions: In a large Japanese AHF population, the grades of TR could successfully stratify the risk of all-cause death. However, the association of TR with mortality was only modest and attenuated in patients aged 80 or more. Further research is warranted to evaluate how to follow up and manage TR in this elderly population.
MeSH term(s)	Humans ; Aged ; Aged, 80 and over ; Tricuspid Valve Insufficiency/complications ; Tricuspid Valve Insufficiency/epidemiology ; Stroke Volume ; Retrospective Studies ; Ventricular Function, Left ; Heart Failure/complications ; Heart Failure/epidemiology ; Registries
Language	English
Publishing date	2023-03-29
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2814355-3
ISSN	2055-5822 ; 2055-5822
ISSN (online)	2055-5822
ISSN	2055-5822
DOI	10.1002/ehf2.14348
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Article ; Online: Prognostic Value of the Severity of Clinical Congestion in Patients Hospitalized for Decompensated Heart Failure: Findings From the Japanese KCHF Registry.

Aida, Kenji / Nagao, Kazuya / Kato, Takao / Yaku, Hidenori / Morimoto, Takeshi / Inuzuka, Yasutaka / Tamaki, Yodo / Yamamoto, Erika / Yoshikawa, Yusuke / Kitai, Takeshi / Taniguchi, Ryoji / Iguchi, Moritake / Kato, Masashi / Takahashi, Mamoru / Jinnai, Toshikazu / Kawai, Takafumi / Komasa, Akihiro / Nishikawa, Ryusuke / Kawase, Yuichi /

Morinaga, Takashi / Su, Kanae / Kawato, Mitsunori / Seko, Yuta / Inada, Tsukasa / Inoko, Moriaki / Toyofuku, Mamoru / Furukawa, Yutaka / Nakagawa, Yoshihisa / Ando, Kenji / Kadota, Kazushige / Shizuta, Satoshi / Ono, Koh / Sato, Yukihito / Kuwahara, Koichiro / Ozasa, Neiko / Kimura, Takeshi

Journal of cardiac failure

2023 Volume 29, Issue 8, Page(s) 1150–1162

Abstract: Background: Congestion is a leading cause of hospitalization and a major therapeutic target in patients with heart failure (HF). Clinical practice in Japan is characterized by a long hospital stay, which facilitates more extensive decongestion during ... ...

Abstract	Background: Congestion is a leading cause of hospitalization and a major therapeutic target in patients with heart failure (HF). Clinical practice in Japan is characterized by a long hospital stay, which facilitates more extensive decongestion during hospitalization. We herein examined the time course and prognostic impact of clinical congestion in a large contemporary Japanese cohort of HF. Methods and results: Peripheral edema, jugular venous pressure, and orthopnea were graded on a standardized 4-point scale (0-3) in 3787 hospitalized patients in a Japanese cohort of HF. Composite Congestion Scores (CCS) on admission and at discharge were calculated by summing individual scores. The primary outcome was a composite of all-cause death or HF hospitalization. The median admission CCS was 4 (interquartile range, 3-6). Overall, 255 patients died during the median hospitalization length of 16 days, and 1395 died or were hospitalized for HF over a median postdischarge follow-up of 396 days. The cumulative 1-year incidence of the primary outcome increased at higher tertiles of congestion on admission (32.5%, 39.3%, and 41.0% in the mild [CCS ≤3], moderate [CCS = 4 or 5], and severe [CCS ≥6] congestion groups, respectively, log-rank P < .001). The adjusted hazard ratios of moderate and severe congestion relative to mild congestion were 1.205 (95% confidence interval [CI], 1.065-1.365; P = .003) and 1.247 (95% CI, 1.103-1.410; P < .001), respectively. Among 3445 patients discharged alive, 85% had CCS of 0 (complete decongestion) and 15% had a CCS of 1 or more (residual congestion) at discharge. Although residual congestion predicted a risk of postdischarge death or HF hospitalization (adjusted hazard ratio, 1.314 [1.145-1.509]; P < .001), the admission CCS correlated with the risk of postdischarge death or HF hospitalization, even in the complete decongestion group. No correlation was observed for postdischarge death or HF hospitalization between residual congestion at discharge and admission CCS (P for the interaction = .316). Conclusions: In total, 85% of patients were discharged with complete decongestion in Japanese clinical practice. Clinical congestion, on admission and at discharge, was of prognostic value. The severity of congestion on admission was predictive of adverse outcomes, even in the absence of residual congestion. Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT02334891 (NCT02334891) https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000017241 (UMIN000015238).
MeSH term(s)	Humans ; Aftercare ; East Asian People ; Heart Failure/diagnosis ; Heart Failure/epidemiology ; Heart Failure/therapy ; Hospitalization ; Hyperemia/complications ; Hyperemia/diagnosis ; Patient Discharge ; Prognosis ; Registries
Language	English
Publishing date	2023-01-21
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	1281194-4
ISSN	1532-8414 ; 1071-9164
ISSN (online)	1532-8414
ISSN	1071-9164
DOI	10.1016/j.cardfail.2023.01.003
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Article ; Online: Life Expectancy of Patients With Severe Aortic Stenosis in Relation to Age and Surgical Risk Score.

Taniguchi, Tomohiko / Morimoto, Takeshi / Yamaji, Kyohei / Shirai, Shinichi / Ando, Kenji / Shiomi, Hiroki / Takeji, Yasuaki / Ohno, Nobuhisa / Kanamori, Norio / Yamazaki, Fumio / Koyama, Tadaaki / Kim, Kitae / Ehara, Natsuhiko / Furukawa, Yutaka / Komiya, Tatsuhiko / Iwakura, Atsushi / Shirotani, Manabu / Esaki, Jiro / Sakaguchi, Genichi /

Fujii, Kosuke / Nakayama, Shogo / Mabuchi, Hiroshi / Tsuneyoshi, Hiroshi / Eizawa, Hiroshi / Shiraga, Kotaro / Hanyu, Michiya / Nakano, Akira / Ishii, Katsuhisa / Tamura, Nobushige / Higashitani, Nobuya / Kouchi, Ichiro / Yamada, Tomoyuki / Nishizawa, Junichiro / Jinnai, Toshikazu / Morikami, Yuko / Minatoya, Kenji / Kimura, Takeshi

The Annals of thoracic surgery

2023 Volume 116, Issue 6, Page(s) 1195–1203

Abstract: Background: There is a paucity of data regarding shorter life expectancy after aortic valve replacement (AVR) in patients with severe aortic stenosis (AS).: Methods: Among 3815 patients with severe AS enrolled in the CURRENT AS (Contemporary outcomes ...

Abstract	Background: There is a paucity of data regarding shorter life expectancy after aortic valve replacement (AVR) in patients with severe aortic stenosis (AS). Methods: Among 3815 patients with severe AS enrolled in the CURRENT AS (Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis) registry, there were 1469 patients (initial AVR: n = 647; conservative strategy: n = 822) with low surgical risk, 1642 patients (initial AVR: n = 433; conservative strategy: n = 1209) with intermediate surgical risk, and 704 patients (initial AVR: n = 117; conservative strategy: n = 587) with high surgical risk. Among 1163 patients who actually underwent surgical AVR as the initial strategy, patients were divided into 4 groups according to age <65 years (n = 185), 65 to 74 (n = 394), 75 to 80 (n = 345), and >80 (n = 239). The expected survival of the general Japanese population was obtained from the Statistics Bureau of Japan. The surgical risk was estimated using The Society of Thoracic Surgery (STS) score. Results: The median follow-up was 3.7 years. The cumulative incidences of all-cause death were significantly lower in the initial AVR strategy than in the initial conservative strategy across the 3 STS groups. Shorter life expectancy after surgical AVR was seen especially in younger patients. The observed mortality in low-risk patients was comparable to the expected mortality across all the age-groups, while intermediate-risk patients aged <75 years, and high-risk patients across all age-groups had higher mortality compared with the expected mortality. Conclusions: The risk stratification according to age and STS score might be useful to estimate shorter life expectancy after AVR, and these findings have implications for decision making in the choice of surgical or transcatheter AVR.
MeSH term(s)	Humans ; Aortic Valve Stenosis ; Treatment Outcome ; Heart Valve Prosthesis Implantation/adverse effects ; Risk Factors ; Aortic Valve/surgery ; Life Expectancy ; Severity of Illness Index
Language	English
Publishing date	2023-02-02
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2023.01.028
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Article ; Online: Newly Diagnosed Infection After Admission for Acute Heart Failure: From the KCHF Registry.

Seko, Yuta / Kato, Takao / Morimoto, Takeshi / Yaku, Hidenori / Inuzuka, Yasutaka / Tamaki, Yodo / Ozasa, Neiko / Shiba, Masayuki / Yamamoto, Erika / Yoshikawa, Yusuke / Yamashita, Yugo / Kitai, Takeshi / Taniguchi, Ryoji / Iguchi, Moritake / Nagao, Kazuya / Jinnai, Toshikazu / Komasa, Akihiro / Nishikawa, Ryusuke / Kawase, Yuichi /

Morinaga, Takashi / Toyofuku, Mamoru / Furukawa, Yutaka / Ando, Kenji / Kadota, Kazushige / Sato, Yukihito / Kuwahara, Koichiro / Kimura, Takeshi

Journal of the American Heart Association

2021 Volume 10, Issue 22, Page(s) e023256

Abstract: Background No studies have explored the association between newly diagnosed infections after admission and clinical outcomes in patients with acute heart failure. We aimed to explore the factors associated with newly diagnosed infection after admission ... ...

Abstract	Background No studies have explored the association between newly diagnosed infections after admission and clinical outcomes in patients with acute heart failure. We aimed to explore the factors associated with newly diagnosed infection after admission for acute heart failure, and its association with in-hospital and post-discharge clinical outcomes. Methods and Results Among 4056 patients enrolled in the Kyoto Congestive Heart Failure registry, 2399 patients without any obvious infectious disease upon admission were analyzed. The major in-hospital and post-discharge outcome measures were all-cause deaths. There were 215 patients (9.0%) with newly diagnosed infections during hospitalization, and 2184 patients (91.0%) without infection during hospitalization. The factors independently associated with a newly diagnosed infection were age ≥80 years, acute coronary syndrome, non-ambulatory status, hyponatremia, anemia, intubation, and patients who were not on loop diuretics as outpatients. The newly diagnosed infection group was associated with a higher incidence of in-hospital mortality (16.3% and 3.2%,
MeSH term(s)	Aftercare ; Aged ; Aged, 80 and over ; Heart Failure/diagnosis ; Heart Failure/epidemiology ; Hospitalization ; Humans ; Patient Discharge ; Registries ; Risk Factors
Language	English
Publishing date	2021-11-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.121.023256
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Article ; Online: Appetite loss at discharge from acute decompensated heart failure: Observation from KCHF registry.

Yamamoto, Erika / Kato, Takao / Yaku, Hidenori / Morimoto, Takeshi / Inuzuka, Yasutaka / Tamaki, Yodo / Ozasa, Neiko / Yoshikawa, Yusuke / Kitai, Takeshi / Taniguchi, Ryoji / Iguchi, Moritake / Kato, Masashi / Takahashi, Mamoru / Jinnai, Toshikazu / Ikeda, Tomoyuki / Nagao, Kazuya / Kawai, Takafumi / Komasa, Akihiro / Nishikawa, Ryusuke /

Kawase, Yuichi / Morinaga, Takashi / Kawato, Mitsunori / Seko, Yuta / Shiba, Masayuki / Toyofuku, Mamoru / Furukawa, Yutaka / Nakagawa, Yoshihisa / Ando, Kenji / Kadota, Kazushige / Shizuta, Satoshi / Ono, Koh / Sato, Yukihito / Kuwahara, Koichiro / Kimura, Takeshi

PloS one

2022 Volume 17, Issue 5, Page(s) e0267327

Abstract: Objective: The complex link between nutritional status, protein and lipid synthesis, and immunity plays an important prognostic role in patients with heart failure. However, the association between appetite loss at discharge and long-term outcome ... ...

Abstract	Objective: The complex link between nutritional status, protein and lipid synthesis, and immunity plays an important prognostic role in patients with heart failure. However, the association between appetite loss at discharge and long-term outcome remains unclear. Methods: The Kyoto Congestive Heart Failure registry is a prospective cohort study that enrolled consecutive patients hospitalized for acute decompensated heart failure (ADHF) in Japan. We assessed 3528 patients alive at discharge, and for whom appetite and follow-up data were available. We compared one-year clinical outcomes in patients with and without appetite loss at discharge. Results: In the multivariable logistic regression analysis using 19 clinical and laboratory factors with P value < 0.1 by univariate analysis, BMI < 22 kg/m2 (odds ratio (OR): 1.57, 95% confidence interval (CI): 1.11-2.24, P = 0.01), CRP >1.0mg/dL (OR: 1.49, 95%CI: 1.04-2.14, P = 0.03), and presence of edema at discharge (OR: 4.30, 95%CI: 2.99-6.22, P<0.001) were associated with an increased risk of appetite loss at discharge, whereas ambulatory status (OR: 0.57, 95%CI: 0.39-0.83, P = 0.004) and the use of ACE-I/ARB (OR: 0.70, 95% CI: 0.50-0.98, P = 0.04) were related to a decreased risk in the presence of appetite loss. The cumulative 1-year incidence of all-cause death (primary outcome measure) was significantly higher in patients with appetite loss than in those without appetite loss (31.0% vs. 15.0%, P<0.001). The excess adjusted risk of appetite loss relative to no appetite loss remained significant for all-cause death (hazard ratio (HR): 1.63, 95%CI: 1.29-2.07, P<0.001). Conclusions: Loss of appetite at discharge was associated with worse 1-year mortality in patients with ADHF. Appetite is a simple, reliable, and useful subjective marker for risk stratification of patients with ADHF.
MeSH term(s)	Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Appetite ; Heart Failure ; Humans ; Patient Discharge ; Prognosis ; Prospective Studies ; Registries
Chemical Substances	Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors
Language	English
Publishing date	2022-05-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0267327
Database	MEDical Literature Analysis and Retrieval System OnLINE

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