22 results on '"Kazuho Kamishima"'
Search Results
2. Prognostic factors in patients with heart failure and sarcopenia: an observational retrospective study
- Author
-
Yasutaka Imamura, Atsushi Suzuki, Kazuho Kamishima, Kazuhito Suzuki, and Junichi Yamaguchi
- Subjects
Brain natriuretic peptide ,Ejection fraction ,Heart failure ,Prognostic factors ,Sarcopenia ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Heart failure (HF) prevalence increases with age, and sarcopenia is a poor prognostic factor in patients with HF. We aimed to evaluate the characteristics and prognostic factors in patients with HF and sarcopenia. Results We retrospectively reviewed 256 consecutive patients admitted to our hospital for HF between May 2018 and May 2021, underwent dual-energy X-ray absorptiometry, and were diagnosed with sarcopenia. The primary endpoint was all-cause mortality. The prognoses and characteristics were evaluated and compared between patients with left ventricular ejection fraction (LVEF)
- Published
- 2024
- Full Text
- View/download PDF
3. A case of variant angina treated with a pacemaker for cardiopulmonary arrest due to complete atrioventricular block and pulseless electrical activity
- Author
-
Kazuho Kamishima, Yuichiro Yamada, Hirotaka Kawarai, Kanako Kudo, Kensuke Shimazaki, Ryuta Henmi, Atsushi Honda, Kazue Gunji, Motoki Uno, and Shoji Haruta
- Subjects
Coronary spastic angina ,Implantable cardioverter defibrillator (ICD) ,Pacemaker ,Pulseless electrical activity (PEA) ,Resuscitation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
A 55-year-old woman with variant angina was hospitalized for cardiopulmonary arrest because of pulseless electrical activity (PEA). Despite intensive postresuscitation drug therapy, another episode of angina occurred, with complete atrioventricular block and PEA. There was no confirmed ventricular fibrillation or ventricular tachycardia. Coronary arteriography did not show significant stenosis, and acetylcholine-loading test was positive. The patient was diagnosed with coronary spastic angina, and a pacemaker was implanted to stabilize hemodynamics during attacks. The pacemaker settings required some ingenuity: a high output was selected to avert pacing failure, and a rate drop response setting was selected to ensure efficient pacing.
- Published
- 2013
- Full Text
- View/download PDF
4. Clinical course of a case of variant angina treated with a pacemaker for cardiopulmonary arrest due to complete atrioventricular block and pulseless electrical activity
- Author
-
Yuichiro Yamada, MD, Kazuho Kamishima, MD, Hirotaka Kawarai, MD, and Shoji Haruta, MD
- Subjects
Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2015
- Full Text
- View/download PDF
5. Direct Oral Anticoagulants Affect Activated Clotting Time During and Bleeding Events After Percutaneous Coronary Intervention
- Author
-
Eiji Shibahashi, Takuro Abe, Kazuho Kamishima, Suguru Ebihara, Tetsu Moriyama, Kensuke Shimazaki, Katsumi Saito, Yasuko Uchigata, and Kentaro Jujo
- Abstract
BackgroundInappropriately high activated clotting time (ACT) during percutaneous coronary intervention (PCI) is associated with an increased risk of bleeding events. However, whether the prescription of direct oral anticoagulants (DOAC) affects ACT kinetics during heparin use and adverse clinical events in patients undergoing PCI remains unclear. To evaluate the ACT changes during and adverse clinical events after PCI in patients who were prescribed DOAC.MethodsThis observational study included 246 patients undergoing PCI at the two cardiovascular centers who were not receiving warfarin and whose ACT was recorded immediately before and 30 min after injection of unfractionated heparin (UFH). Patients were divided into two groups according to DOAC prescription at the time of the index PCI: DOAC users (n=31) and non-users (n=215). Any bleeding and systemic thromboembolic events were investigated until 30 days after PCI.ResultsThe average age of this population was 70.5 years, and 66.3% were male. Average ACT was significantly higher in DOAC users than non-users both before and 30 min after UFH induction (157.2 ± 30.1 vs. 131.8 ± 25.1 sec, pConclusionPatients receiving DOAC have higher ACTs during PCI and higher incidence of bleeding events than those not receiving DOAC.CONDENSED ABSTRACTChanges in activated clotting time (ACT) and incidence of systemic thromboembolic and bleeding events in patients undergoing percutaneous coronary intervention (PCI) using conventional heparin were compared between those receiving direct oral anticoagulants (DOAC) and those who were not. ACT both before and 30 min after initial heparin injection was higher in patients who received DOAC than in those who did not. DOAC prescription did not affect the incidence of systemic thromboembolic events. Conversely, patients receiving DOAC more frequently experienced post-PCI bleeding events than those not receiving DOAC.
- Published
- 2023
6. Abstract 14077: One-year Outcome After PCI in Patients Treated Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers - Subanalysis From Multicenter Registry
- Author
-
Fumiaki Mori, Junichi Yamaguchi, Hiroshi Koganei, Kazuho Kamishima, Hiroshi Kobayashi, Nobuhisa Hagiwara, Tomohiro Sakamoto, Yoshimi Ota, Inagaki Yusuke, Kentaro Jujo, Toshiaki Oka, and Hiroyuki Tanaka
- Subjects
biology ,business.industry ,Angiotensin-converting enzyme ,Pharmacology ,Angiotensin II ,Physiology (medical) ,ACE inhibitor ,Conventional PCI ,medicine ,biology.protein ,In patient ,cardiovascular diseases ,Angiotensin Receptor Blockers ,Medical prescription ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Background: The prescription of inhibitors for renin-angiotensin-aldosterone system (RAAS) is associated with improved prognosis but have respectively different mechanisms of action in patients with coronary artery disease (CAD). We aimed to compare the clinical outcomes between angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) therapy in patients with CAD undergoing percutaneous coronary intervention (PCI). Methods: This study is a subanalysis from the TWINCRE registry that is a multicentral prospective cohort including patients who underwent PCI. After excluding 18 patients who received both ACEi and ARB from 2,896 registered patients, we ultimately evaluated 369 patients treated with ACEi, 492 with ARB and 541 without ACEi or ARB. The primary endpoint was a major adverse cardiovascular and cerebrovascular events (MACCE) including death from any cause, acute coronary syndrome, stent thrombosis, stroke and hospitalization for heart failure. The impact of RAAS inhibitors on all-cause mortality alone was also evaluated. Results: During the observation period with 366 days of a median follow-up, Kaplan-Meier analysis revealed that the ARB group had the lowest rate of MACCE than other two groups (Log-rank for trend, p< for < 0.0001, Figure). Regarding all-cause mortality, the ARB group and ACEi group had comparable rates for MACCE, which were lower than the no-ACEi/ARB group (p< for < 0.0001). In a Cox regression analysis, after adjusting with age, gender, comorbidities, multivessel disease, acute myocardial infarction, and medications at discharge including dual antiplatelet therapy and statins, ARB therapy was still had a superiority to ACEi therapy regarding with MACCE (hazard ratio: 0.54, 95% confidence interval: 0.30-0.98). Conclusion: In the multicenter cohort study, ARB therapy was associated with better one-year clinical outcomes compared to ACEi therapy in patients undergoing PCI.
- Published
- 2020
7. Abstract 14931: Low-Dose Prasugrel Has Prognostic Superiority to Clopidogrel in High-Bleeding Risk Patients Undergoing Contemporary Percutaneous Coronary Intervention
- Author
-
Nobuhisa Hagiwara, Takehiro Hata, Kazuho Kamishima, Hiroshi Koganei, Kentaro Jujo, Junichi Yamaguchi, Tomohiro Sakamoto, and Takuro Abe
- Subjects
Aspirin ,medicine.medical_specialty ,Prasugrel ,P2Y12 Receptor Antagonists ,business.industry ,medicine.medical_treatment ,Low dose ,Percutaneous coronary intervention ,Clopidogrel ,Physiology (medical) ,Internal medicine ,Conventional PCI ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Introduction: The combination of aspirin and P2Y12 receptor antagonist is the standard antiplatelet therapy after percutaneous coronary intervention (PCI). Previous trials reported that prasugrel reduced the risk of ischemic events, but increased bleeding events compared to clopidogrel. Hypothesis: The prognostic impact of low-dose prasugrel (3.75 mg/day), which the dose was determined by phase II trial, is different from that of clopidogrel, depending on patient’s bleeding risk. Methods: This study is a subanalysis from the TWINCRE registry that is a multicentral prospective cohort including patients who underwent PCI. We analyzed 1,001 patients who received the combination of aspirin and prasugrel or clopidogrel after PCI. The primary endpoint was a composite of major bleeding event and major adverse cardiovascular and cerebrovascular events (MACCE) including any death, acute coronary syndrome, stent thrombosis, stroke and heart failure hospitalization. Results: There were 490 patients with high bleeding risk (HBR) and 511 patients with low bleeding risk (LBR), based on ARC-HBR criteria. In HBR patients, the Low-dose prasugrel group had significantly lower rates of MACCE (Log-rank, p=0.003) and the composite endpoint than the Clopidogrel group (p=0.001). While, in LBR patients, there was no significant difference in rates of MACCE or the composite endpoint between the groups (p=0.76, p=0.15, respectively), and a higher rate of major bleeding event in the Low-dose prasugrel group (p=0.002). With Cox proportional hazards analysis, low-dose prasugrel has still retained the superiority to clopidogrel regarding with the composite endpoint in HBR patients, even after adjusting with diverse covariates (hazard ratio: 0.33, 95% confidence interval: 0.16-0.65). Conclusion: In the multicenter cohort study in Japan, low-dose prasugrel showed a long-term prognostic superiority to clopidogrel only in HBR patients undergoing contemporary PCI.
- Published
- 2020
8. Real-world antithrombotic therapies and clinical outcomes after second-generation drug-eluting stent implantation in patients with atrial fibrillation: a multi-center cohort study
- Author
-
Nobuhisa Hagiwara, Kazuho Kamishima, Hiroyuki Arashi, Hisao Otsuki, and Junichi Yamaguchi
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Administration, Oral ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Prosthesis Design ,Coronary Restenosis ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Fibrinolytic Agents ,Japan ,Internal medicine ,Atrial Fibrillation ,Antithrombotic ,medicine ,Humans ,Registries ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Postoperative Care ,Dose-Response Relationship, Drug ,business.industry ,Incidence ,Warfarin ,Percutaneous coronary intervention ,Drug-Eluting Stents ,Atrial fibrillation ,Vascular surgery ,medicine.disease ,Stroke ,Treatment Outcome ,Drug-eluting stent ,Conventional PCI ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,medicine.drug ,Cohort study - Abstract
Previous reports have focused on cardiovascular and bleeding events in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). However, antithrombotic treatment strategies and clinical outcomes after second-generation drug-eluting stents (DES) implantation in AF patients remain to be determined. We enrolled 244 consecutive AF patients treated with second-generation DES. The study population was derived from multi-center AF registry (including 8 centers in Japan) from 2010 to 2012. Prescription of antithrombotic agents and clinical outcomes were retrospectively examined. Ninety-two patients (37.7%) were prescribed dual antiplatelet therapy (DAPT) at discharge and 152 patients (62.3%) were given DAPT plus oral anticoagulation (OAC) with warfarin. The median follow-up period was 730 days. Kaplan–Meier analysis showed that major adverse cardiac and cerebrovascular events (MACCE) were not significantly different (2-year event rate, 17.6 vs. 13.5%, p = 0.37), but bleeding events were significantly higher in the DAPT plus OAC group than in the DAPT group (2-year event rate, 6.1 vs. 17.9%, p = 0.033). In a sub-analysis of DAPT plus OAC patients, adequate time in the therapeutic range (TTR) group (TTR ≥ 65%) was not significantly different from the suboptimal OAC group (TTR
- Published
- 2018
9. The impact of tissue Doppler index E/e′ ratio on instantaneous wave-free ratio
- Author
-
Hisao Otsuki, Junichi Yamaguchi, Yuichiro Minami, Hiroshi Ogawa, Kazuho Kamishima, Kentaro Jujo, Tonre Ri, Hiroyuki Arashi, Masashi Nakao, and Nobuhisa Hagiwara
- Subjects
Male ,medicine.medical_specialty ,Rest ,Diastole ,Blood Pressure ,Fractional flow reserve ,030204 cardiovascular system & hematology ,Doppler echocardiography ,Coronary Angiography ,Severity of Illness Index ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Mass index ,030212 general & internal medicine ,Instantaneous wave-free ratio ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Coronary Stenosis ,Reproducibility of Results ,Coronary flow reserve ,Middle Aged ,medicine.disease ,Echocardiography, Doppler ,Fractional Flow Reserve, Myocardial ,Stenosis ,Blood pressure ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background The instantaneous wave-free ratio (iFR) is a vasodilator-free, invasive pressure wire index of the functional severity of coronary stenosis and is calculated under resting conditions. In a recent study, iFR was found to be more closely linked to coronary flow reserve (CFR) than fractional flow reserve (FFR). E/e′ is a surrogate marker of left ventricular (LV) filling pressure and LV diastolic dysfunction. Coronary resting flow was found to be increased in patients with elevated E/e′, and higher coronary resting flow was associated with lower CFR. Higher baseline coronary flow induces a greater loss of translesional pressure and may affect iFR. However, no reports have examined the impact of E/e′ on iFR. The purpose of this study was to assess the relationship between iFR and E/e′ compared with FFR. Methods and results We retrospectively examined 103 consecutive patients (142 with stenosis) whose iFR, FFR, and E/e′ were measured simultaneously. The mean age, LV mass index, and systolic blood pressure of patients with elevated E/e′ were higher than those of patients with normal E/e′. Although no significant differences were observed in mean FFR values and % diameter stenosis, the mean iFR value in patients with elevated E/e′ was significantly lower than that in patients with normal E/e′. The iFR was negatively correlated with E/e′, while there was no correlation between FFR and E/e′. Multivariate analysis showed that E/e′ and % diameter stenosis were independent determinants of iFR. Conclusion E/e′ ratio affects iFR values. Our results suggest that FFR mainly reflects the functional severity of the epicardial stenosis whereas iFR could potentially be influenced by not only epicardial stenosis but also other factors related to LV filling pressure or LV diastolic dysfunction. Further research is needed to understand the underlying mechanisms that influence the evaluation of iFR in patients with elevated E/e′.
- Published
- 2018
10. Lesion characteristics of coronary arteries associated with a mismatch between angiographic severity of stenosis and fractional flow reserve
- Author
-
Hisao Otsuki, Kazuho Kamishima, Masashi Nakao, Yuichiro Minami, Junichi Yamaguchi, Nobuhisa Hagiwara, Hiroshi Ogawa, Mayui Nakazawa, Hiroyuki Arashi, Atsushi Takagi, Kentaro Jujo, and Shintaro Haruki
- Subjects
Male ,Cardiac Catheterization ,medicine.medical_specialty ,Ischemia ,Fractional flow reserve ,030204 cardiovascular system & hematology ,Coronary Angiography ,Severity of Illness Index ,Lesion ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Receiver operating characteristic ,business.industry ,Coronary Stenosis ,Curve analysis ,General Medicine ,medicine.disease ,Coronary Vessels ,Fractional Flow Reserve, Myocardial ,Coronary arteries ,Stenosis ,medicine.anatomical_structure ,ROC Curve ,Cardiology ,Female ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,Artery - Abstract
We aimed to clarify the relationships between angiographic lesion characteristics and values of fractional flow reserve (FFR) on intermediate coronary artery stenosis. The clinical meaning and assessment for "visual-functional mismatches," including regular-mismatches [defined as angiographic percent diameter stenosis (%DS) ≥50 % and FFR >0.80] and reverse-mismatches (defined as angiographic %DS
- Published
- 2016
11. Percutaneous Coronary Intervention for Left Main Compression Syndrome due to Severe Idiopathic Pulmonary Arterial Hypertension: One Year Follow-up Using Intravascular Imaging
- Author
-
Naoki Serizawa, Nobuhisa Hagiwara, Junichi Yamaguchi, Masataka Ogiso, and Kazuho Kamishima
- Subjects
medicine.medical_specialty ,Exacerbation ,Hypertension, Pulmonary ,medicine.medical_treatment ,Idiopathic Pulmonary Hypertension ,Pulmonary Artery ,Percutaneous Coronary Intervention ,Infusion therapy ,Internal medicine ,Intravascular ultrasound ,Internal Medicine ,medicine ,Humans ,Myocardial infarction ,Antihypertensive Agents ,Ultrasonography, Interventional ,medicine.diagnostic_test ,business.industry ,Coronary Stenosis ,Percutaneous coronary intervention ,Syndrome ,General Medicine ,Middle Aged ,medicine.disease ,Epoprostenol ,Pulmonary hypertension ,Treatment Outcome ,medicine.anatomical_structure ,Cardiology ,Female ,Stents ,Radiology ,business ,Tomography, Optical Coherence ,Follow-Up Studies ,Artery - Abstract
A 60-year-old woman presented with ST-elevation myocardial infarction due to extrinsic compression of the left main coronary artery (LMCA) caused by a dilated pulmonary artery (PA) with idiopathic pulmonary hypertension and was successfully treated with intravascular ultrasound- and optical coherence tomography-guided stenting. Continuous subcutaneous epoprostenol infusion therapy was initiated immediately after the procedure and increased aggressively. Imaging modalities were extremely useful in making the diagnosis and providing follow-up of LMCA compression syndrome in this case. Over the one-year observation period, a sufficient hemodynamic improvement was obtained, without exacerbation of the PA dilatation, resulting in the absence of compression of the LMCA.
- Published
- 2015
12. Evaluation of the cut-off value for the instantaneous wave-free ratio of patients with aortic valve stenosis
- Author
-
Nobuhisa Hagiwara, Masashi Nakao, Hiroyuki Arashi, Kazuho Kamishima, Kazuki Tanaka, Kentaro Jujo, Hiroshi Ogawa, Hisao Otsuki, Junichi Yamaguchi, Tonre Ri, and Yuichiro Minami
- Subjects
Male ,medicine.medical_specialty ,Cardiac Catheterization ,Diastole ,Fractional flow reserve ,030204 cardiovascular system & hematology ,Coronary Angiography ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Instantaneous wave-free ratio ,Contraindication ,Aged ,medicine.diagnostic_test ,business.industry ,Cut off value ,Diastolic phase ,Coronary Stenosis ,Interventional radiology ,General Medicine ,Aortic Valve Stenosis ,medicine.disease ,Fractional Flow Reserve, Myocardial ,ROC Curve ,Aortic valve stenosis ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
The aim of this study was to examine the clinical value of iFR for AS patients. Functional evaluation of coronary stenosis in patients with aortic valve stenosis (AS) is challenging because the stress-induced test is often thought to be a contraindication. AS patients have a unique coronary flow pattern dependent on the diastolic phase. The instantaneous wave-free ratio (iFR) is a vasodilator-free, invasive pressure wire index of the functional severity of coronary stenosis and is calculated under resting conditions. And iFR calculated during a specific period of diastole may have the potential benefit to assess the functional severity of coronary stenosis in AS patients. We examined 158 consecutive patients (217 stenoses) whose iFR and fractional flow reserve (FFR) were measured simultaneously. Among the 158 patients, AS was observed in 13 (8.2%). The iFR showed good correlation with FFR in AS patients. The best cut-off value of iFR for the receiver-operator curve analysis to predict FFR of 0.8 was 0.9 for non-AS patients. However, it was 0.73 for AS patients. The present study demonstrated good correlation between iFR and FFR for AS patients. Vasodilator-free assessment using iFR may provide potential benefits when evaluating coronary stenosis in patients with AS. In AS patients, the best cut-off of iFR value predicting FFR value of 0.8 was lower than 0.9 that is the standard predictive value of iFR.
- Published
- 2017
13. Effect of concurrent elevation of serum creatinine and C-reactive protein values on the long-term outcome in patients with ST-elevation acute myocardial infarction
- Author
-
Nobuhisa Hagiwara, Atsushi Honda, Junichi Yamaguchi, Hiroshi Ogawa, and Kazuho Kamishima
- Subjects
medicine.medical_specialty ,Creatinine ,biology ,business.industry ,ST elevation ,C-reactive protein ,Elevation ,medicine.disease ,chemistry.chemical_compound ,chemistry ,Internal medicine ,medicine ,biology.protein ,Cardiology ,In patient ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business - Published
- 2015
14. TCTAP C-125 Severe Tortuous RCA PCI Successfully Treated by Using Guideliner Catheter
- Author
-
Hisao Otsuki, Junichi Yamaguchi, Kazuho Kamishima, Kentaro Jujo, Masashi Nakao, and Nobuhisa Hagiwara
- Subjects
medicine.medical_specialty ,Catheter ,surgical procedures, operative ,business.industry ,Conventional PCI ,Medicine ,cardiovascular diseases ,business ,Cardiology and Cardiovascular Medicine ,Surgery - Published
- 2015
- Full Text
- View/download PDF
15. A case of variant angina treated with a pacemaker for cardiopulmonary arrest due to complete atrioventricular block and pulseless electrical activity
- Author
-
Motoki Uno, Yuichiro Yamada, Ryuta Henmi, Kazue Gunji, Kazuho Kamishima, Hirotaka Kawarai, Shoji Haruta, Kanako Kudo, Kensuke Shimazaki, and Atsushi Honda
- Subjects
Pulseless electrical activity (PEA) ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Resuscitation ,medicine.medical_specialty ,business.industry ,Coronary spastic angina ,Hemodynamics ,medicine.disease ,Ventricular tachycardia ,Pacemaker ,Angina ,Stenosis ,lcsh:RC666-701 ,Internal medicine ,Ventricular fibrillation ,Pulseless electrical activity ,medicine ,Cardiology ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business ,Atrioventricular block ,Implantable cardioverter defibrillator (ICD) - Abstract
A 55-year-old woman with variant angina was hospitalized for cardiopulmonary arrest because of pulseless electrical activity (PEA). Despite intensive postresuscitation drug therapy, another episode of angina occurred, with complete atrioventricular block and PEA. There was no confirmed ventricular fibrillation or ventricular tachycardia. Coronary arteriography did not show significant stenosis, and acetylcholine-loading test was positive. The patient was diagnosed with coronary spastic angina, and a pacemaker was implanted to stabilize hemodynamics during attacks. The pacemaker settings required some ingenuity: a high output was selected to avert pacing failure, and a rate drop response setting was selected to ensure efficient pacing.
- Published
- 2013
16. Association of New York Heart Association functional class IV symptoms at admission and clinical features with outcomes in patients hospitalized for acute heart failure syndromes
- Author
-
Ryo Sugiura, Naoki Sato, Tetsuo Hirata, Kazuho Kamishima, Hisayuki Okada, Ryotaro Asano, Katsuya Kajimoto, and Toshiaki Oka
- Subjects
Male ,medicine.medical_specialty ,Acute decompensated heart failure ,030204 cardiovascular system & hematology ,Risk Assessment ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Patient Admission ,Japan ,Internal medicine ,Cause of Death ,medicine ,Risk of mortality ,Clinical endpoint ,Humans ,Clinical significance ,In patient ,030212 general & internal medicine ,Hospital Mortality ,Prospective Studies ,Registries ,Intensive care medicine ,Aged ,Heart Failure ,Inpatients ,business.industry ,Mortality rate ,Syndrome ,medicine.disease ,Prognosis ,Heart failure ,Acute Disease ,Etiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
It remains unclear whether there are subgroups of acute heart failure syndromes (AHFS) patients in whom New York Heart Association (NYHA) class IV symptoms at admission is related to a higher risk of mortality because of the heterogeneity of this patient population. The aim of this study was to evaluate the association of NYHA class IV symptoms at baseline with in-hospital mortality in subgroups of patients with AHFS.Of the 4842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 4786 patients were included in this analysis. The primary endpoint was in-hospital all-cause death. NYHA class IV at baseline was detected in 44.3% of the patients. The all-cause death rate was significantly higher in patients with NYHA class IV than in those with NYHA class II or III (9.0% vs. 4.3%, P0.001). To examine the heterogeneity of the association between NYHA class IV symptoms at baseline and in-hospital mortality, subgroup analyses were performed. As a result, the presence of NYHA class IV symptoms on admission was associated with a significantly higher risk of all-cause death in patients aged ≥75years, female patients, patients without an idiopathic dilated etiology, and patients with preserved ejection fraction (EF).This study demonstrated that an age≥75years, female gender, the absence of idiopathic dilated etiology, and a preserved EF should be considered when assessing the clinical significance of NYHA class IV symptoms in relation to the risk of in-hospital mortality in patients hospitalized for AHFS.
- Published
- 2016
17. Abstract 9916: Evaluation of the Best Cut-off Value of Ischemia in Instantaneous Wave-Free Ratio in Patients With Aortic Valve Stenosis
- Author
-
Tonre Ri, Shintarou Haruki, Nobuhisa Hagiwara, Masashi Nakao, Kentaro Jujo, Junichi Yamaguchi, Eiji Shibahashi, Kensuke Shimazaki, Yuichiro Minami, Hiroyuki Arashi, Kazuho Kamishima, Hisao Otsuki, and Ryosuke Itani
- Subjects
Overall pressure ratio ,medicine.medical_specialty ,business.industry ,Diastole ,Ischemia ,medicine.disease ,Coronary artery disease ,Coronary circulation ,medicine.anatomical_structure ,Physiology (medical) ,Aortic valve stenosis ,Internal medicine ,Cardiology ,Medicine ,In patient ,Instantaneous wave-free ratio ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: Instantaneous wave-free ratio (iFR) is a vasodilator free index calculated using trans-lesional pressure ratio during a specific period of diastole that is called “wave-free period”, and reported to have a good correlation with fractional flow reserve (FFR). In patients with severe aortic valve stenosis (AS), evaluation of intermediate coronary stenosis by FFR using vasodilators is thought to be a contraindication in some situations. Moreover, previous studies reported unique coronary flow pattern during diastolic phase in patients with AS. To date, there is no report claiming the correlation of iFR and FFR in this population. The purpose of the present study was to examine the clinical value of iFR in patients with AS. Method and Results: We examined consecutive 154 patients (with 214 stenosis) whose iFR and FFR were measured simultaneously. The mean age of AS patients (n=10, mean aortic valve area: 0.75 ± 0.42cm2) was higher than non-AS patients (n=144). Other patients’ characteristics are shown in Table 1. The mean iFR value in AS patients was significantly lower than that of non-AS patients, despite no significant difference was observed in the mean FFR value and % diameter stenosis (Table 2). iFR showed a good correlation with FFR in AS patients (Figure 1) and the best cut-off value of iFR in receiver operator curve analysis to predict FFR ≤ 0.8 was 0.73 in AS patients (AUC 0.84, sensitivity 0.8, specificity 0.86, p=0.016; Figure 2), whereas, 0.90 in non-AS patients. Conclusion: The present study demonstrated the good correlation between iFR and FFR in AS patients. Besides, the value below 0.73 of iFR was thought to be a predictor of myocardial ischemia in AS patients, which was lower than standard predictive range of ischemia in iFR. Vasodilator-free assessment by iFR may have potential benefits in evaluating intermediate coronary stenosis in patients with AS.
- Published
- 2015
18. Abstract 18886: Predictors for Long-term Clinical Outcomes After Endovascular Treatment in Patients With Critical Limb Ischemia
- Author
-
Kentaro Jujo, Masashi Nakao, Junichi Yamaguchi, Hisao Otsuki, Kensuke Shimazaki, Kazuho Kamishima, Hiroyuki Arashi, and Nobuhisa Hagiwara
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Backgrounds: Critical limb ischemia (CLI) is a severe clinical presentation of patients with peripheral artery disease, and their limb salvage and survival rates are extremely poor. However, there is still only limited evidence from observational studies for contemporary outcomes in CLI patients who underwent endovascular treatment (EVT) including both above and below the knee lesion. Therefore, this study aimed to evaluate the prognostic and predictive factors for patients with CLI who underwent EVT. Methods: Cumulative total number of 192 patients with CLI who underwent EVT between March 2009 and April 2014 was prospectively enrolled. After the exclusion of patients who were lost to follow-up within 6 months, 175 patients were retrospectively analyzed for clinical and angiographic parameters. The primary endpoints of this study were all-cause death and major amputation above the ankle joint. Results: The study population was typically elderly (average age: 68 year-old) and 76% male with a normal body mass index (BMI: 23 kg/m2) and diverse comorbidities, including 34% diabetes and 72% maintenance hemodialysis. Target lesions consisted of 23% aortoiliac, 56% femoropopliteal and 67% below-the-knee arteries, including 37% isolated below-the-knee lesion. Median follow-up period was 23.9 months. Survival rate and major amputation free rate at 1-year were 87% and 95%, respectively (Figure). Multivariate analysis elucidated that low BMI and cerebrovascular disease were independent predictors for all-cause mortality (Table 1). Interestingly, infection was the leading cause of death (23 patients (46%), and main focus of infection was lower extremities (15 patients (30%)). As for major limb amputation, current smoking was the only independent predictor (Table 2). Conclusion: This study demonstrates that low BMI and cerebrovascular disease predict all-cause mortality, and current smoking does major amputation after EVT in patients with CLI.
- Published
- 2015
19. Effect of Hemodialysis on 7-Year Clinical Outcomes After Sirolimus-Eluting Stent Implantation
- Author
-
Nobuhisa Hagiwara, Nozima Buronova, Yusuke Inagaki, Akira Wada, Kentaro Jujo, Masahiro Watanabe, Dai Okayama, Norihiro Yamada, Atsushi Takagi, Kazuho Kamishima, Junichi Yamaguchi, Shinya Hatakeyama, Hiroshi Ogawa, Hiroyuki Arashi, Masashi Nakao, Shohei Kishi, and Erisa Watanabe
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Coronary Artery Disease ,Disease-Free Survival ,Coronary artery disease ,Percutaneous Coronary Intervention ,Asian People ,Japan ,Interquartile range ,Renal Dialysis ,Risk Factors ,Internal medicine ,Medicine ,Humans ,Survival rate ,Aged ,Retrospective Studies ,Sirolimus ,business.industry ,Hazard ratio ,Age Factors ,Percutaneous coronary intervention ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,medicine.disease ,Survival Rate ,Conventional PCI ,Cardiology ,Female ,Hemodialysis ,Cardiology and Cardiovascular Medicine ,business ,Mace ,Follow-Up Studies - Abstract
BACKGROUND Hemodialysis (HD) patients are reported to show poor clinical outcomes after percutaneous coronary intervention (PCI) with sirolimus-eluting stent (SES) compared with non-HD patients and their long-term prognosis remains unclear. METHODS AND RESULTS We prospectively enrolled 489 consecutive patients undergoing PCI with SES and performed a retrospective analysis focusing on HD patients. Median follow-up was 7.0 years (interquartile range, 4.2-7.9) and the follow-up rate was 100%. At the 7-year follow-up, the cumulative incidences of all-cause death, target lesion revascularization (TLR) and major adverse cardiac events (MACE) were significantly higher in HD patients than in non-HD patients (HD vs. non-HD=34.7% vs. 9.6%, 42.6% vs. 10.2% and 75.3% vs. 24.4%, respectively; log-rank P
- Published
- 2015
20. Clinical course of a case of variant angina treated with a pacemaker for cardiopulmonary arrest due to complete atrioventricular block and pulseless electrical activity
- Author
-
Shoji Haruta, Yuichiro Yamada, Kazuho Kamishima, and Hirotaka Kawarai
- Subjects
Bradycardia ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,business.industry ,Clinical course ,Paroxysmal Atrioventricular Block ,medicine.disease ,ANGINA ATTACK ,Angina ,lcsh:RC666-701 ,Internal medicine ,Pulseless electrical activity ,medicine ,Cardiology ,cardiovascular diseases ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Atrioventricular block ,Letter to the Editor ,Effective response - Abstract
In the Journal of Arrhythmia, we previously reported the case of a 55-year-old woman with variant angina who was implanted with a pacemaker to treat cardiopulmonary arrest due to complete atrioventricular block and pulseless electrical activity [1]. In this report, we follow the clinical outcome of the pacemaker implantation in this patient. Upon implantation, we simulated the proper and effective response of the pacemaker to prepare for the possibility that the patient might encounter coronary ischemia-induced bradycardia. A high output setting was selected in order to prevent pacing failure and a rate drop response (RDR) setting was selected both to ensure efficient pacing in the case of an angina attack and to conserve battery power during periods when there was no angina. Three years have passed since the pacemaker was implanted. During this time, the patient appears to have been in remission of vasospastic activity and the patient is doing well without symptomatic angina. We also evaluated the pacemaker data and found that an episode of paroxysmal atrioventricular block occurred asymptomatically and that the RDR response was functioning appropriately (Fig. 1). Finally, the ventricular pacing rate was 0.4% and the average battery longevity was 11.5 years (range, 9.5–13 years), which was longer than that of the ordinary setting. Fig. 1 The pacemaker electrocardiogram; a rate drop response (RDR) was activated after an episode of paroxysmal atrioventricular block.
- Published
- 2015
- Full Text
- View/download PDF
21. Abstract 12865: Predictors of 'Visual-Functional Mismatch' in Contemporary Practice -The Lesion Characteristics Associating With Mismatch Between Angiographic Stenosis and Fractional Flow Reserve
- Author
-
Hiroyuki Arashi, Junichi Yamaguchi, Kazuho Kamishima, Shintarou Haruki, Hisao Otsuki, Masashi Nakao, Dai Okayama, Yukiko Sashida, Yuichirou Minami, and Nobuhisa Hagiwara
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Background: The benefit of fractional flow reserve (FFR) guided percutaneous coronary intervention (PCI) in patients with coronary artery disease compared with angio-guided PCI has shown recently. However, the argument for mismatch (angiographic diameter stenosis ≧ 50% and FFR > 0.80) or reverse-mismatch (angiographic diameter stenosis < 50%, FFR ≦ 0.80), so called, “visual-functional mismatch”, is remains to be solved in contemporary practice. In the present study, we examined the association of the lesion characteristics and “visual-functional mismatch”. Method and Results: We analyzed 140 consecutive patients (157 lesions) undergoing coronary angiography and FFR examination. The mean age of study population was 68.7 years old, 54.3% of them had diabetes, 87.9% of them had hypertension and 77.1% of them had dyslipidemia. In terms of lesion characteristics, ratio of LAD lesion was 58.6%, tandem or diffuse lesion was 48.4%, mean percentage of diameter stenosis was 68.2% and lesion length was 16.3mm. The study population was divided into 4 groups by angiographic stenosis (cut-off: 50%) and FFR (cut-off: 0.80). There were no differences in patients’ background among 4 groups. Mismatches were observed in 28.7% of lesions, whereas, reverse-mismatches were observed in 10.1% of lesions. Lesion characteristics causing “visual-functional mismatch” are shown in Table 1 and ROC curve s of diameter stenosis for functional significance are shown in Figure 1. Conclusion: Specific lesion characteristics are applicable for predicting “visual-functional mismatch”. Angiographic severity seemed to be more reliable in LAD lesions, tandem/diffuse lesions or proximal lesions. FFR measurement should be considered for angiographic 50% stenosis in LAD to perform appropriate PCI, whereas, FFR measurement should be considered for angiographic 75% stenosis in non-LAD to avoid unnecessary PCI.
- Published
- 2014
22. Effect of concurrent elevation of serum creatinine and C-reactive protein values on the long-term outcome in patients with ST-elevation acute myocardial infarction.
- Author
-
Kazuho Kamishima, Junichi Yamaguchi, Atsushi Honda, Hiroshi Ogawa, and Nobuhisa Hagiwara
- Subjects
- *
CREATININE , *BLOOD serum analysis , *C-reactive protein , *MYOCARDIAL infarction , *HEALTH outcome assessment - Published
- 2015
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.