5 results on '"Kitamura M"'
Search Results
2. The impact of biventricular heart failure on outcomes after transcatheter aortic valve implantation.
- Author
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Schmidt T, Bohné M, Schlüter M, Kitamura M, Wohlmuth P, Schewel D, Schewel J, Schmoeckel M, Kuck KH, and Frerker C
- Subjects
- Acute Disease, Aged, 80 and over, Aortic Valve Stenosis complications, Aortic Valve Stenosis physiopathology, Echocardiography, Transesophageal, Female, Follow-Up Studies, Germany epidemiology, Heart Failure diagnosis, Heart Failure epidemiology, Hemodynamics physiology, Humans, Incidence, Male, Postoperative Period, Prognosis, Retrospective Studies, Risk Factors, Survival Rate trends, Treatment Outcome, Aortic Valve Stenosis surgery, Heart Failure etiology, Risk Assessment, Transcatheter Aortic Valve Replacement methods
- Abstract
Aims: We sought to assess the impact of different manifestations of heart failure (HF) at baseline on the short- and long-term outcomes of transcatheter aortic valve implantation (TAVI) for aortic stenosis (AS)., Methods and Results: Of 361 patients undergoing TAVI between May 2013 and April 2015, 185 (51%) showed clinical signs of HF at the time of admission. HF was diagnosed as isolated left ventricular (LV) and biventricular in 63 (34%) and 122 patients (66%), respectively. Acute device success (VARC-2) was achieved in 97% of patients without HF, in all patients with LV HF, and in 97% of patients with biventricular HF. Follow-up for a median of 427 days revealed significantly poorer survival in patients with biventricular HF (1-year estimate, 72.1% [95% confidence interval, 64.0-80.2%]) than in patients with LV HF (84.5% [75.2-93.8%]; p = 0.0203) or no HF (94.3% [90.7-97.9%]; p < 0.0001). Survival in the latter two patient subgroups was statistically not different. A diagnosis of biventricular HF was associated with a hazard ratio of 2.62 (p = 0.0089) vs. no HF in the likelihood of death; NT-proBNP and the logistic EuroSCORE were not significantly associated with survival. Half of all deaths in patients with biventricular HF occurred within 42 days of TAVI., Conclusion: Biventricular HF is a strong predictor of mortality following TAVI for severe AS. AS in patients with LV HF should be treated without delay to avoid progression to biventricular HF. Patients with AS and biventricular HF should be monitored closely after TAVI to possibly prevent early death.
- Published
- 2019
- Full Text
- View/download PDF
3. Predictive impact of previous coronary artery bypass grafting on mortality after MitraClip implantation for ischemic functional mitral regurgitation.
- Author
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Kitamura M, Kaneko H, Schlüter M, Schewel D, Schmidt T, Alessandrini H, Kreidel F, Okamoto M, Neuss M, Butter C, Kuck KH, and Frerker C
- Subjects
- Aged, Female, Follow-Up Studies, Germany epidemiology, Humans, Male, Mitral Valve Insufficiency etiology, Mitral Valve Insufficiency mortality, Myocardial Ischemia mortality, Myocardial Ischemia surgery, Postoperative Period, Prognosis, Prosthesis Design, Retrospective Studies, Survival Rate trends, Coronary Artery Bypass methods, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation methods, Mitral Valve Insufficiency surgery, Myocardial Ischemia complications
- Abstract
Background: Many candidates with ischaemic functional mitral regurgitation (FMR) have previously undergone coronary artery bypass grafting (CABG), in which transcatheter mitral valve repair can be reasonable for ameliorating the deteriorated hemodynamic and heart failure symptoms. We sought to elucidate the outcomes of MitraClip (MC) implantation in patients with symptomatic ischaemic FMR after CABG., Methods: We investigated clinical characteristics, outcomes and predictive impact of previous CABG on mortality in ischaemic FMR patients who underwent MC implantation from two high-volume centres in Germany., Results: We enrolled 159 patients who previously underwent CABG. Compared with a reference group that did not previously undergo CABG (n = 182), the cohort consisted of more elderly patients (75.0, standard deviation [SD] 7.7 versus 72.9, SD 9.6 years, p = 0.028), more men (84% vs. 69%, p < 0.001), and reduced tricuspid annular plane systolic excursion (14.0, SD 4.0, vs. 16.6, SD 4.6 mm, p < 0.0001). The CABG group showed similar outcomes regarding procedural success (91% vs. 94%, p = 0.24) and 30-day mortality (5.0% vs. 6.0%, p = 0.68), but worse survival after MC implantation (log-rank p = 0.019, hazard ratio 1.56 [95% confidence interval (CI) 1.08-2.26]). After propensity score matching (n = 224), the hazard ratio was 1.18 [95%CI 0.76-1.84] without statistical significance (p = 0.46)., Conclusions: Transcatheter mitral valve repair using the MC is a viable treatment option for patients with symptomatic ischaemic FMR after CABG. Although the baseline characteristics seemed to point to sick patients, CABG itself had only a modest impact on survival., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
4. Predictors of mortality in ischaemic versus non-ischaemic functional mitral regurgitation after successful transcatheter mitral valve repair using MitraClip: results from two high-volume centres.
- Author
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Kitamura M, Kaneko H, Schlüter M, Schewel D, Schmidt T, Alessandrini H, Kreidel F, Neuss M, Butter C, Kuck KH, and Frerker C
- Subjects
- Aged, Cause of Death trends, Coronary Angiography, Coronary Vessels diagnostic imaging, Female, Germany epidemiology, Heart Ventricles diagnostic imaging, Heart Ventricles physiopathology, Humans, Incidence, Male, Mitral Valve diagnostic imaging, Mitral Valve Insufficiency etiology, Mitral Valve Insufficiency surgery, Myocardial Ischemia diagnosis, Myocardial Ischemia mortality, Postoperative Complications epidemiology, Prognosis, Prosthesis Design, Retrospective Studies, Survival Rate trends, Systole, Treatment Outcome, Cardiac Catheterization methods, Heart Valve Prosthesis Implantation methods, Hospitals, High-Volume statistics & numerical data, Mitral Valve surgery, Mitral Valve Insufficiency epidemiology, Myocardial Ischemia complications, Ventricular Function, Left physiology
- Abstract
Introduction: Transcatheter edge-to-edge mitral valve repair using the MitraClip has been widely performed in surgical high-risk patients with reduced left ventricular systolic function and severe functional mitral regurgitation (FMR). Ischaemic heart disease is the leading aetiology of heart disease worldwide. We aimed to assess the clinical implications of ischaemic aetiology in patients with severe FMR who underwent MitraClip implantation., Methods and Results: From two high-volume centres in Germany, we retrospectively compared the clinical outcomes and clinical predictors of all-cause mortality after MitraClip implantation in patients with ischaemic (I-FMR) and non-ischaemic FMR (NI-FMR). In the overall FMR cohort (n = 575), there were 336 (58%) patients with I-FMR and 239 (42%) with NI-FMR. There was no significant difference in survival between the two groups (log-rank p = 0.78). In a multivariable Cox regression analysis of all-cause mortality, different predictors were observed for either group. In I-FMR patients, decreasing tricuspid annular systolic excursion [adjusted hazard ratio (HR
adj ) 1.06, 95% confidence interval (95% CI) 1.01-1.14 /1 mm, p = 0.028] and increasing logistic EuroSCORE (HRadj 1.02, 95% CI 1.00-1.03, p = 0.037) were independent predictors, whereas in NI-FMR patients, NT-pro BNP (HRadj 1.05, 95% CI 1.02-1.08, p = 0.001) and age (HRadj 1.06, 95% CI 1.01-1.11, p = 0.013) were independently predictive of mortality., Conclusions: Despite the similar survival between ischaemic and non-ischaemic FMR, different predictors of all-cause mortality were demonstrated. Further clinical studies are mandated to focus on each FMR subgroup with stratification by ischaemic origin.- Published
- 2019
- Full Text
- View/download PDF
5. ["The Trojan horse" and civic society: the Berlin administration and housing issues, 1820-31].
- Author
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Kitamura M
- Subjects
- Berlin ethnology, Germany ethnology, History, 19th Century, Local Government history, Urban Health history, Urban Population history, Housing economics, Housing history, Housing legislation & jurisprudence, Public Assistance economics, Public Assistance history, Public Assistance legislation & jurisprudence, Public Policy economics, Public Policy history, Public Policy legislation & jurisprudence, Residence Characteristics, Social Class history, Socioeconomic Factors
- Published
- 2001
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