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Start Over Author "Takenobu Shimada" Journal journal of the american heart association
3 results on '"Takenobu Shimada"'

1. Prognostic Impact of Aortic Valve Area in Conservatively Managed Patients With Asymptomatic Severe Aortic Stenosis With Preserved Ejection Fraction

Author

Norio Kanamori, Tomohiko Taniguchi, Takeshi Morimoto, Hirotoshi Watanabe, Hiroki Shiomi, Kenji Ando, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Makoto Miyake, Hirokazu Mitsuoka, Masashi Kato, Yutaka Hirano, Shintaro Matsuda, Kazuya Nagao, Tsukasa Inada, Hiroshi Mabuchi, Yasuyo Takeuchi, Keiichiro Yamane, Mamoru Toyofuku, Mitsuru Ishii, Eri Minamino‐Muta, Takao Kato, Moriaki Inoko, Tomoyuki Ikeda, Akihiro Komasa, Katsuhisa Ishii, Kozo Hotta, Nobuya Higashitani, Yoshihiro Kato, Yasutaka Inuzuka, Chiyo Maeda, Toshikazu Jinnai, Yuko Morikami, Naritatsu Saito, Kenji Minatoya, Takeshi Aoyama, Takeshi Kimura, Ryuzo Sakata, Masao Imai, Junichi Tazaki, Toshiaki Toyota, Hirooki Higami, Tetsuma Kawaji, Shinichi Shirai, Kengo Korai, Takeshi Arita, Shiro Miura, Kyohei Yamaji, Kitae Kim, Keiichiro Iwasaki, Hiroshi Miyawaki, Ayumi Misao, Akimune Kuwayama, Masanobu Ohya, Takenobu Shimada, Hidewo Amano, Masashi Amano, Yusuke Takahashi, Yusuke Yoshikawa, Shunsuke Nishimura, Maiko Kuroda, Tetsu Mizoguchi, Takafumi Yokomatsu, Akihiro Kushiyama, Hidenori Yaku, Toshimitsu Watanabe, Sachiko Sugioka, Naoki Takahashi, Kohei Fukuchi, Teruki Takeda, Tomoko Sakaguchi, Keiko Maeda, Masayuki Yamaji, Motoyoshi Maenaka, Yutaka Tadano, Makoto Motooka, Ryusuke Nishikawa, Mitsunori Kawato, Minako Kinoshita, Kenji Aida, Kousuke Takahashi, Euihong Ko, Nobutoyo Masunaga, Hisashi Ogawa, Moritake Iguchi, Takashi Unoki, Kensuke Takabayashi, Yasuhiro Hamatani, Yugo Yamashita, Shuhei Tsuji, Soji Nishio, Jyunya Seki, Miho Yamada, Akira Kawamoto, Kouji Sogabe, Michiya Tachiiri, Yukiko Matsumura, Chihiro Ota, Kenji Minakata, Michiya Hanyu, Fumio Yamazaki, Tadaaki Koyama, Tatsuhiko Komiya, Kazuo Yamanaka, Noboru Nishiwaki, Hiroyuki Nakajima, Motoaki Ohnaka, Hiroaki Osada, Katsuaki Meshii, Toshihiko Saga, Masahiko Onoe, Hitoshi Kitayama, Shogo Nakayama, Genichi Sakaguchi, Atsushi Iwakura, Kotaro Shiraga, Koji Ueyama, Keiichi Fujiwara, Atsushi Fukumoto, Senri Miwa, Junichiro Nishizawa, Mitsuru Kitano, Kenji Nakatsuma, and Tomoki Sasa

Subjects
medicine.medical_specialty, Aortic Valve Replacement/Transcather Aortic Valve Implantation, aortic valve stenosis, 030204 cardiovascular system & hematology, Severity of Illness Index, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Aortic valve replacement, Internal medicine, medicine, asymptomatic, echocardiography, Humans, aortic valve replacement, 030212 general & internal medicine, Adverse effect, Original Research, Heart Valve Prosthesis Implantation, Ejection fraction, business.industry, Background data, Stroke Volume, Prognosis, medicine.disease, Stenosis, Aortic valve area, Valvular Heart Disease, Aortic Valve, Aortic valve stenosis, Asymptomatic Diseases, Cardiology, medicine.symptom, Cardiology and Cardiovascular Medicine, business, aortic valve area
Abstract

Background Data are scarce on the role of aortic valve area (AVA) to identify those patients with asymptomatic severe aortic stenosis (AS) who are at high risk of adverse events. We sought to explore the prognostic impact of AVA in asymptomatic patients with severe AS in a large observational database. Methods and Results Among 3815 consecutive patients with severe AS enrolled in the CURRENT AS (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis) registry, the present study included 1309 conservatively managed asymptomatic patients with left ventricular ejection fraction ≥50%. The study patients were subdivided into 3 groups based on AVA (group 1: AVA >0.80 cm2, N=645; group 2: 0.8 cm2 ≥AVA >0.6 cm2, N=465; and group 3: AVA ≤0.6 cm2, N=199). The prevalence of very severe AS patients (peak aortic jet velocity ≥5 m/s or mean aortic pressure gradient ≥60 mm Hg) was 2.0%, 5.8%, and 26.1% in groups 1, 2, and 3, respectively. The cumulative 5‐year incidence of AVR was not different across the 3 groups (39.7%, 43.7%, and 39.9%; P=0.43). The cumulative 5‐year incidence of the primary outcome measure (a composite of aortic valve–related death or heart failure hospitalization) was incrementally higher with decreasing AVA (24.1%, 29.1%, and 48.1%; P, See Editorial by Tribouilloy et al

Published
2019

2. Severe Aortic Stenosis in Dialysis Patients

Author

Akimune Kuwayama, Tatsuhiko Komiya, Katsuhisa Ishii, Takeshi Maruo, Yasushi Fuku, Michiya Hanyu, Keiichiro Iwasaki, Tsukasa Inada, Kazushige Kadota, Tomohiko Taniguchi, Takeshi Kimura, Yuichi Kawase, Takeshi Morimoto, Eri Minamino-Muta, Moriaki Inoko, Kenji Minatoya, Hidewo Amano, Masanobu Ohya, Takeshi Kitai, Takao Kato, Takenobu Shimada, Naritatsu Saito, and Chisato Izumi

Subjects
Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, 030232 urology & nephrology, 030204 cardiovascular system & hematology, Dialysis patients, Severity of Illness Index, Sudden death, 03 medical and health sciences, 0302 clinical medicine, Japan, Aortic valve replacement, Renal Dialysis, Risk Factors, Cause of Death, Internal medicine, medicine, Humans, Registries, Original Research, Aged, Retrospective Studies, Aged, 80 and over, Heart Valve Prosthesis Implantation, hemodialysis, Medical treatment, business.industry, Incidence (epidemiology), aortic stenosis, Cardiovascular Agents, Aortic Valve Stenosis, Protective Factors, medicine.disease, Surgery, Stenosis, Treatment Outcome, Valvular Heart Disease, Cohort, Cardiology, Female, Kidney Diseases, prognosis, Hemodialysis, Cardiology and Cardiovascular Medicine, business
Abstract

Background Characteristics and prognosis of hemodialysis patients with severe aortic stenosis have not yet been well defined. Methods and Results The CURRENT AS (contemporary outcomes after surgery and medical treatment in patients with severe aortic stenosis) registry, a Japanese multicenter registry, enrolled 3815 consecutive patients with severe aortic stenosis. There were 405 hemodialysis patients (initial aortic valve replacement [ AVR ] group: N=135 [33.3%], and conservative group: N=270) and 3410 nonhemodialysis patients (initial AVR group: N=1062 [31.1%], and conservative group: N=2348). The median follow‐up duration after the index echocardiography was 1361 days, with 90% follow‐up rate at 2 years. The cumulative 5‐year incidence of all‐cause death was significantly higher in hemodialysis patients than in nonhemodialysis patients in both the entire cohort (71% versus 40%, P AVR group (63.2% versus 17.9%, P AVR group as compared with the conservative group was associated with significantly lower cumulative 5‐year incidences of all‐cause death (60.6% versus 75.5%, P P AVR procedure, was markedly higher in the hemodialysis patients than in the nonhemodialysis patients (21.2% and 2.3%, P Conclusions Among hemodialysis patients with severe aortic stenosis, the initial AVR strategy as compared with the conservative strategy was associated with significantly lower long‐term mortality risk, particularly the risk for sudden death, although the effect size for the survival benefit of the initial AVR strategy was smaller than that in the nonhemodialysis patients.

Published
2017

3. Prognostic Impact of Peak Aortic Jet Velocity in Conservatively Managed Patients With Severe Aortic Stenosis: An Observation From the CURRENT AS Registry

Author

Kenji Nakatsuma, Tomohiko Taniguchi, Takeshi Morimoto, Hiroki Shiomi, Kenji Ando, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Makoto Miyake, Hirokazu Mitsuoka, Masashi Kato, Yutaka Hirano, Shintaro Matsuda, Tsukasa Inada, Kazuya Nagao, Tomoyuki Murakami, Yasuyo Takeuchi, Keiichiro Yamane, Mamoru Toyofuku, Mitsuru Ishii, Eri Minamino‐Muta, Takao Kato, Moriaki Inoko, Tomoyuki Ikeda, Akihiro Komasa, Katsuhisa Ishii, Kozo Hotta, Nobuya Higashitani, Yoshihiro Kato, Yasutaka Inuzuka, Chiyo Maeda, Toshikazu Jinnai, Yuko Morikami, Naritatsu Saito, Kenji Minatoya, Takeshi Kimura, Masao Imai, Junichi Tazaki, Toshiaki Toyota, Hirooki Higami, Tetsuma Kawaji, Shinichi Shirai, Kengo Korai, Takeshi Arita, Shiro Miura, Kyohei Yamaji, Kitae Kim, Keiichiro Iwasaki, Hiroshi Miyawaki, Ayumi Misao, Akimune Kuwayama, Masanobu Ohya, Takenobu Shimada, Hidewo Amano, Masashi Amano, Yusuke Takahashi, Yusuke Yoshikawa, Shunsuke Nishimura, Maiko Kuroda, Tetsu Mizoguchi, Takafumi Yokomatsu, Akihiro Kushiyama, Hidenori Yaku, Toshimitsu Watanabe, Sachiko Sugioka, Naoki Takahashi, Kohei Fukuchi, Hiroshi Mabuchi, Teruki Takeda, Tomoko Sakaguchi, Masayuki Yamaji, Motoyoshi Maenaka, Yutaka Tadano, Makoto Motooka, Ryusuke Nishikawa, Mitsunori Kawato, Minako Kinoshita, Kenji Aida, Kousuke Takahashi, Euihong Ko, Nobutoyo Masunaga, Hisashi Ogawa, Moritake Iguchi, Takashi Unoki, Kensuke Takabayashi, Yasuhiro Hamatani, Yugo Yamashita, Shuhei Tsuji, Soji Nishio, Jyunya Seki, Miho Yamada, Akira Kawamoto, Kouji Sogabe, Michiya Tachiiri, Yukiko Matsumura, Chihiro Ota, Ryuzo Sakata, Kenji Minakata, Michiya Hanyu, Fumio Yamazaki, Tadaaki Koyama, Tatsuhiko Komiya, Kazuo Yamanaka, Noboru Nishiwaki, Motoaki Ohnaka, Hiroaki Osada, Katsuaki Meshii, Toshihiko Saga, Hitoshi Kitayama, Shogo Nakayama, Genichi Sakaguchi, Atsushi Iwakura, Kotaro Shiraga, Koji Ueyama, Keiichi Fujiwara, Atsushi Fukumoto, Senri Miwa, Junichiro Nishizawa, Mitsuru Kitano, Hirotoshi Watanabe, and Tomoki Sasa

Subjects
Male, Aortic valve, Time Factors, Hemodynamics, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Severity of Illness Index, Ventricular Function, Left, 0302 clinical medicine, Japan, Risk Factors, Registries, 030212 general & internal medicine, Original Research, Aged, 80 and over, Stroke volume, clinical outcomes, Hospitalization, Treatment Outcome, medicine.anatomical_structure, Aortic Valve, Aortic valve stenosis, Cardiology, Female, Cardiology and Cardiovascular Medicine, peak aortic jet velocity, medicine.medical_specialty, 03 medical and health sciences, Internal medicine, Severity of illness, medicine, Humans, Aged, Proportional Hazards Models, Retrospective Studies, Heart Failure, Chi-Square Distribution, business.industry, aortic stenosis, Stroke Volume, Retrospective cohort study, Aortic Valve Stenosis, medicine.disease, Surgery, Stenosis, Valvular Heart Disease, Heart failure, Asymptomatic Diseases, business
Abstract

Background There are limited data regarding the risk stratification based on peak aortic jet velocity (Vmax) in patients with severe aortic stenosis ( AS ). Methods and Results Among 3815 consecutive patients with severe AS enrolled in the CURRENT AS (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis) registry, the study population consisted of 1075 conservatively managed patients with Vmax ≥4.0 m/s and left ventricular ejection fraction ≥50%. The study patients were subdivided into 3 groups based on Vmax (group 1, 4.0 ≤ Vmax AS ‐related events (aortic valve–related death or heart failure hospitalization) was incrementally higher with increasing Vmax (entire population; 38.0%, 49.4%, and 62.8%, P P =0.008; and asymptomatic patients; 29.4%, 38.9%, and 47.7%, P =0.005). After adjusting for confounders, the excess risk of group 2 and group 3 relative to group 1 for AS ‐related events remained significant (hazard ratio, 1.39; 95% CI , 1.07–1.81; P =0.02, and hazard ratio, 1.53; 95% CI , 1.17–2.00; P =0.002, respectively). The effect size of group 3 relative to group 1 for AS ‐related events in asymptomatic patients (N=479) was similar to that in symptomatic patients (N=596; hazard ratio, 1.59; 95% CI , 1.01–2.52; P =0.047, and hazard ratio, 1.67; 95% CI , 1.16–2.40, P =0.008, respectively), and there was no significant overall interaction between the symptomatic status and the effect of the Vmax categories on AS ‐related events (interaction, P =0.88). Conclusions In conservatively managed severe AS patients with preserved left ventricular ejection fraction, increasing Vmax was associated with incrementally higher risk for AS ‐related events. However, the cumulative 5‐year incidence of the AS ‐related events remained very high even in asymptomatic patients with less greater Vmax.

Published
2017

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