217 results on '"Yamanaka F"'
Search Results
2. Vascular healing of Combo plus stents in patients with acute coronary syndrome
- Author
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Shishido, K, primary, Miyashita, H, additional, Yokoyama, H, additional, Yamashita, T, additional, Ochiai, T, additional, Yamaguchi, M, additional, Moriyama, N, additional, Tobita, K, additional, Matsumoto, T, additional, Mizuno, S, additional, Yamanaka, F, additional, Tanaka, Y, additional, Murakami, M, additional, Takahashi, S, additional, and Saito, S, additional
- Published
- 2023
- Full Text
- View/download PDF
3. Impact of periprocedural pulmonary hypertension on outcomes after TAVR: novel risk stratification from the OCEAN-TAVI Registry
- Author
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Miyamoto, J, primary, Ohno, Y, additional, Ikari, Y, additional, Tada, N, additional, Naganuma, T, additional, Yamawaki, M, additional, Yamanaka, F, additional, Shirai, S, additional, Mizutani, K, additional, Tabata, M, additional, Ueno, H, additional, Takagi, K, additional, Watanabe, Y, additional, Yamamoto, M, additional, and Hayashida, K, additional
- Published
- 2022
- Full Text
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4. Clinical outcomes of patients with diffuse coronary artery disease following physiology-guided treatment strategy: insights from AJIP registry
- Author
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Warisawa, T, primary, Cook, C.M, additional, Howard, J.P, additional, Nour, D, additional, Doi, S, additional, Nakayama, M, additional, Uetani, T, additional, Yamanaka, F, additional, Kikuta, Y, additional, Shiono, Y, additional, Nishina, H, additional, Matsuo, H, additional, Escaned, J, additional, Akashi, Y.J, additional, and Davies, J.E, additional
- Published
- 2020
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- View/download PDF
5. Fractional flow reserve and instantaneous wave-free ratio discordance in patients with severe aortic valve stenosis
- Author
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Yamanaka, F, primary, Shishido, K, additional, Yokota, S, additional, Moriyama, N, additional, Mashimo, Y, additional, Hayashi, T, additional, Miyashita, H, additional, Yokoyama, H, additional, Tobita, K, additional, Mizuno, S, additional, Tanaka, Y, additional, Murakami, M, additional, Takahashi, S, additional, Tsujita, K, additional, and Saito, S, additional
- Published
- 2020
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- View/download PDF
6. 803 Clinical Outcomes of Patients With Diffuse Coronary Artery Disease Following Physiology-Guided Treatment Strategy: Insights From AJIP Registry
- Author
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Warisawa, T., primary, M. Cook, C., additional, Nour, D., additional, P. Howard, J., additional, Rajkumar, C., additional, Seligman, H., additional, Ahmad, Y., additional, Doi, S., additional, Nakajima, A., additional, Nakayama, M., additional, Goto, S., additional, Yamanaka, F., additional, Kikuta, Y., additional, Yakuta, Y., additional, Karube, K., additional, Uetani, T., additional, Shiono, Y., additional, Kawase, Y., additional, Nishina, H., additional, Matsuo, H., additional, Escaned, J., additional, J. Akashi, Y., additional, and E. Davies, J., additional
- Published
- 2020
- Full Text
- View/download PDF
7. Recurrent herpes simplex virus infection in a patient with autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy associated with L29P and IVS9-1G>C compound heterozygous autoimmune regulator gene mutations
- Author
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Nagafuchi, S., Umene, K., Yamanaka, F., Oohashi, S., Shindo, M., Kurisaki, H., Kudoh, J., Shimizu, N., Hara, T., and Harada, M.
- Published
- 2007
8. P6524The comparison of radial artery occlusion rate after distal radial artery puncture between hemodialysis and non-hemodialysis patients
- Author
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Yokota, S, primary, Tobita, K, additional, Hayashi, T, additional, Mashimo, Y, additional, Miyashita, H, additional, Yokoyama, H, additional, Nishimoto, T, additional, Shishido, K, additional, Yamanaka, F, additional, Mizuno, S, additional, Murakami, M, additional, Tanaka, Y, additional, Takahashi, S, additional, and Saito, S, additional
- Published
- 2019
- Full Text
- View/download PDF
9. 2018Optical coherence tomographic analysis of in-scaffold atherosclerosis after bioresorbable vascular scaffold implantation at five year follow up
- Author
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Moriyama, N., primary, Shishido, K., additional, Takuma, T., additional, Tobita, K., additional, Tsukuda, S., additional, Yamanaka, F., additional, Mizuno, S., additional, Tanaka, Y., additional, Murakami, M., additional, Matsumi, J., additional, Takahashi, S., additional, and Saito, S., additional
- Published
- 2017
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10. P502Twelve-year clinical outcomes in patients with unprotected left main coronary artery disease after percutaneous coronary intervention with bare metal stent
- Author
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Moriyama, N., primary, Tanaka, Y., additional, Takada, T., additional, Tsukuda, S., additional, Tobita, K., additional, Yamanaka, F., additional, Mizuno, S., additional, Murakami, M., additional, Matsumi, J., additional, Takahashi, S., additional, and Saito, S., additional
- Published
- 2017
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11. Using state-space techniques to represent frequency dependent single-phase lines directly in time domain
- Author
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Kurokawa, S., primary, Yamanaka, F. N. R., additional, Prado, A. J., additional, and Pissolato, J., additional
- Published
- 2008
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12. Recurrent herpes simplex virus infection in a patient with autoimmune polyendocrinopathy?candidiasis?ectodermal dystrophy associated with L29P and IVS9-1G>C compound heterozygous autoimmune regulator gene mutations
- Author
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Nagafuchi, S., primary, Umene, K., additional, Yamanaka, F., additional, Oohashi, S., additional, Shindo, M., additional, Kurisaki, H., additional, Kudoh, J., additional, Shimizu, N., additional, Hara, T., additional, and Harada, M., additional
- Published
- 2007
- Full Text
- View/download PDF
13. 2 W reliable operation in 50 [micro sign]m-wide InGaAsP/InGaP/AlGaAs ( = 810 nm) SQW diode lasers with tensile-strained InGaP barriers
- Author
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Yamanaka, F., primary, Wada, M., additional, Kuniyasu, T., additional, Ohgoh, T., additional, Fukunaga, T., additional, and Hayakawa, T., additional
- Published
- 2001
- Full Text
- View/download PDF
14. Effects of broad-waveguide structure in 0.8 μm high-power InGaAsP/InGaP/AlGaAs lasers
- Author
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Hayakawa, T., primary, Wada, M., additional, Yamanaka, F., additional, Asano, H., additional, Kuniyasu, T., additional, Ohgoh, T., additional, and Fukunaga, T., additional
- Published
- 1999
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15. Application of the intelligent alarm system for the plant operation
- Author
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Yamanaka, F, primary
- Published
- 1997
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16. Effects of broad-waveguide structure in 0.8 MUm high-power InGaAsP/InGaP/AlGaAs lasers.
- Author
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Hayakawa, T., Wada, M., Yamanaka, F., Asano, H., Kuniyasu, T., Ohgoh, T., and Fukunaga, T.
- Subjects
WAVEGUIDES ,HETEROSTRUCTURES - Abstract
Reports on the systematic study on the effects of the waveguide thickness on separate-confinement-heterostructure lasers. Reduction in the internal loss; external differential quantum efficiency; Increase in carrier overflow in competition with the reduction of optical power density.
- Published
- 1999
- Full Text
- View/download PDF
17. Representation of transmission lines by means of variables of state taking into consideration the effect of the frequency on the longitudinal parameters,Representação de linhas de transmissão por meio de variáveis de estado levando em consideração o efeito da frequência sobre os parâmetros longitudinais
- Author
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Kurokawa, S., Do Prado, A. J., Yamanaka, F. N. R., Bovolato, L. F., and Pissolato, J.
18. Appearance of symtom and Biophyiaxis
- Author
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Yamanaka, F., primary
- Published
- 1976
- Full Text
- View/download PDF
19. 2 W reliable operation in 50 µm-wide InGaAsP/InGaP/AlGaAs (λ = 810 nm) SQW diode lasers with tensile-strained InGaP barriers.
- Author
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Yamanaka, F., Wada, M., Kuniyasu, T., Ohgoh, T., Fukunaga, T., and Hayakawa, T.
- Published
- 2001
- Full Text
- View/download PDF
20. Search for diboson resonances with boson-tagged jets in pp collisions at s=13 TeV with the ATLAS detector
- Author
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Aaboud, M., Aad, G., Abbott, B., Abdinov, O., Abeloos, B., Abidi, S. H., Abouzeid, O. S., Abraham, N. L., Abramowicz, H., Abreu, H., Abreu, R., Abulaiti, Y., Acharya, B. S., Adachi, S., Adamczyk, L., Adelman, J., Adersberger, M., Adye, T., Affolder, A. A., Afik, Y., Agatonovic-Jovin, T., Agheorghiesei, C., Aguilar-Saavedra, J. A., Ahlen, S. P., Ahmadov, F., Aielli, G., Akatsuka, S., Akerstedt, H., Ã…kesson, T. P. A., Akilli, E., Akimov, A. V., Alberghi, G. L., Albert, J., Albicocco, P., Alconada Verzini, M. J., Alderweireldt, S. C., Aleksa, M., Aleksandrov, I. N., Alexa, C., Alexander, G., Alexopoulos, T., Alhroob, M., Ali, B., Aliev, M., Alimonti, G., Alison, J., Alkire, S. P., Allbrooke, B. M. M., Allen, B. W., Allport, P. P., Aloisio, A., Alonso, A., Alonso, F., Alpigiani, C., Alshehri, A. A., Alstaty, M. I., Alvarez Gonzalez, B., Ãlvarez Piqueras, D., Alviggi, M. G., Amadio, B. T., Amaral Coutinho, Y., Amelung, C., Amidei, D., Amor Dos Santos, S. P., Amoroso, S., Amundsen, G., Anastopoulos, C., Ancu, L. S., Andari, N., Andeen, T., Anders, C. F., Anders, J. K., Anderson, K. J., Andreazza, A., Andrei, V., Angelidakis, S., Angelozzi, I., Angerami, A., Anisenkov, A. V., Anjos, N., Annovi, A., Antel, C., Antonelli, M., Antonov, A., Antrim, D. J., Anulli, F., Aoki, M., Aperio Bella, L., Arabidze, G., Arai, Y., Araque, J. P., Araujo Ferraz, V., Arce, A. T. H., Ardell, R. E., Arduh, F. A., Arguin, J. -. F., Argyropoulos, S., Arik, M., Armbruster, A. J., Armitage, L. J., Arnaez, O., Arnold, H., Arratia, M., Arslan, O., Artamonov, A., Artoni, G., Artz, S., Asai, S., Asbah, N., Ashkenazi, A., Asquith, L., Assamagan, K., Astalos, R., Atkinson, M., Atlay, N. B., Augsten, K., Avolio, G., Axen, B., Ayoub, M. K., Azuelos, G., Baas, A. E., Baca, M. J., Bachacou, H., Bachas, K., Backes, M., Bagnaia, P., Bahmani, M., Bahrasemani, H., Baines, J. T., Bajic, M., Baker, O. K., Bakker, P. J., Baldin, E. M., Balek, P., Balli, F., Balunas, W. K., Banas, E., Bandyopadhyay, A., Banerjee, S. w., Bannoura, A. A. E., Barak, L., Barberio, E. L., Barberis, D., Barbero, M., Barillari, T., Barisits, M. -. S., Barkeloo, J. T., Barklow, T., Barlow, N., Barnes, S. L., Barnett, B. M., Barnett, R. M., Barnovska-Blenessy, Z., Baroncelli, A., Barone, G., Barr, A. J., Barranco Navarro, L., Barreiro, F., Barreiro Guimarães da Costa, J., Bartoldus, R., Barton, A. E., Bartos, P., Basalaev, A., Bassalat, A., Bates, R. L., Batista, S. J., Batley, J. R., Battaglia, M., Bauce, M., Bauer, F., Bawa, H. S., Beacham, J. B., Beattie, M. D., Beau, T., Beauchemin, P. H., Bechtle, P., Beck, H. P., Beck, H. C., Becker, K., Becker, M., Becot, C., Beddall, A. J., Beddall, A., Bednyakov, V. A., Bedognetti, M., Bee, C. P., Beermann, T. A., Begalli, M., Begel, M., Behr, J. K., Bell, A. S., Bella, G., Bellagamba, L., Bellerive, A., Bellomo, M., Belotskiy, K., Beltramello, O., Belyaev, N. L., Benary, O., Benchekroun, D., Bender, M., Benekos, N., Benhammou, Y., Benhar Noccioli, E., Benitez, J., Benjamin, D. P., Benoit, M., Bensinger, J. R., Bentvelsen, S., Beresford, L., Beretta, M., Berge, D., Bergeaas Kuutmann, E., Berger, N., Beringer, J., Berlendis, S., Bernard, N. R., Bernardi, G., Bernius, C., Bernlochner, F. U., Berry, T., Berta, P., Bertella, C., Bertoli, G., Bertram, I. A., Bertsche, C., Bertsche, D., Besjes, G. J., Bessidskaia Bylund, O., Bessner, M., Besson, N., Bethani, A., Bethke, S., Betti, A., Bevan, A. J., Beyer, J., Bianchi, R. M., Biebel, O., Biedermann, D., Bielski, R., Bierwagen, K., Biesuz, N. V., Biglietti, M., Billoud, T. R. V., Bilokon, H., Bindi, M., Bingul, A., Bini, C., Biondi, S., Bisanz, T., Bittrich, C., Bjergaard, D. M., Black, J. E., Black, K. M., Blair, R. E., Blazek, T., Bloch, I., Blocker, C., Blue, A., Blum, W., Blumenschein, U., Blunier, S., Bobbink, G. J., Bobrovnikov, V. S., Bocchetta, S. S., Bocci, A., Bock, C., Boehler, M., Boerner, D., Bogavac, D., Bogdanchikov, A. G., Bohm, C., Boisvert, V., Bokan, P., Bold, T., Boldyrev, A. S., Bolz, A. E., Bomben, M., Bona, M., Boonekamp, M., Borisov, A., Borissov, G., Bortfeldt, J., Bortoletto, D., Bortolotto, V., Boscherini, D., Bosman, M., Bossio Sola, J. D., Boudreau, J., Bouffard, J., Bouhova-Thacker, E. V., Boumediene, D., Bourdarios, C., Boutle, S. K., Boveia, A., Boyd, J., Boyko, I. R., Bozson, A. J., Bracinik, J., Brandt, A., Brandt, G., Brandt, O., Braren, F., Bratzler, U., Brau, B., Brau, J. E., Breaden Madden, W. D., Brendlinger, K., Brennan, A. J., Brenner, L., Brenner, R., Bressler, S., Briglin, D. L., Bristow, T. M., Britton, D., Britzger, D., Brochu, F. M., Brock, I., Brock, R., Brooijmans, G., Brooks, T., Brooks, W. K., Brosamer, J., Brost, E., Broughton, J. H., Bruckman de Renstrom, P. A., Bruncko, D., Bruni, A., Bruni, G., Bruni, L. S., Bruno, S., Brunt, B. H., Bruschi, M., Bruscino, N., Bryant, P., Bryngemark, L., Buanes, T., Buat, Q., Buchholz, P., Buckley, A. G., Budagov, I. A., Buehrer, F., Bugge, M. K., Bulekov, O., Bullock, D., Burch, T. J., Burdin, S., Burgard, C. D., Burger, A. M., Burghgrave, B., Burka, K., Burke, S., Burmeister, I., Burr, J. T. P., Busato, E., Bã¼scher, D., Bã¼scher, V., Bussey, P., Butler, J. M., Buttar, C. M., Butterworth, J. M., Butti, P., Buttinger, W., Buzatu, A., Buzykaev, A. R., Cabrera Urbán, S., Caforio, D., Cai, H., Cairo, V. M., Cakir, O., Calace, N., Calafiura, P., Calandri, A., Calderini, G., Calfayan, P., Callea, G., Caloba, L. P., Calvente Lopez, S., Calvet, D., Calvet, S., Calvet, T. P., Camacho Toro, R., Camarda, S., Camarri, P., Cameron, D., Caminal Armadans, R., Camincher, C., Campana, S., Campanelli, M., Camplani, A., Campoverde, A., Canale, V., Cano Bret, M., Cantero, J., Cao, T., Capeans Garrido, M. D. M., Caprini, I., Caprini, M., Capua, M., Carbone, R. M., Cardarelli, R., Cardillo, F., Carli, I., Carli, T., Carlino, G., Carlson, B. T., Carminati, L., Carney, R. M. D., Caron, S., Carquin, E., Carrã¡, S., Carrillo-Montoya, G. D., Casadei, D., Casado, M. P., Casolino, M., Casper, D. W., Castelijn, R., Castillo Gimenez, V., Castro, N. F., Catinaccio, A., Catmore, J. R., Cattai, A., Caudron, J., Cavaliere, V., Cavallaro, E., Cavalli, D., Cavalli-Sforza, M., Cavasinni, V., Celebi, E., Ceradini, F., Cerda Alberich, L., Cerqueira, A. S., Cerri, A., Cerrito, L., Cerutti, F., Cervelli, A., Cetin, S. A., Chafaq, A., Chakraborty, D., Chan, S. K., Chan, W. S., Chan, Y. L., Chang, P., Chapman, J. D., Charlton, D. G., Chau, C. C., Chavez Barajas, C. A., Che, S., Cheatham, S., Chegwidden, A., Chekanov, S., Chekulaev, S. V., Chelkov, G. A., Chelstowska, M. A., Chen, C., Chen, H., Chen, J., Chen, S., Chen, X., Chen, Y., Cheng, H. C., Cheng, H. J., Cheplakov, A., Cheremushkina, E., Cherkaoui El Moursli, R., Cheu, E., Cheung, K., Chevalier, L., Chiarella, V., Chiarelli, G., Chiodini, G., Chisholm, A. S., Chitan, A., Chiu, Y. H., Chizhov, M. V., Choi, K., Chomont, A. R., Chouridou, S., Chow, Y. S., Christodoulou, V., Chu, M. C., Chudoba, J., Chuinard, A. J., Chwastowski, J. J., Chytka, L., Ciftci, A. K., Cinca, D., Cindro, V., Cioara, I. A., Ciocio, A., Cirotto, F., Citron, Z. H., Citterio, M., Ciubancan, M., Clark, A., Clark, B. L., Clark, M. R., Clark, P. J., Clarke, R. N., Clement, C., Coadou, Y., Cobal, M., Coccaro, A., Cochran, J., Colasurdo, L., Cole, B., Colijn, A. P., Collot, J., Colombo, T., Conde Muiño, P., Coniavitis, E., Connell, S. H., Connelly, I. A., Constantinescu, S., Conti, G., Conventi, F., Cooke, M., Cooper-Sarkar, A. M., Cormier, F., Cormier, K. J. R., Corradi, M., Corriveau, F., Cortes-Gonzalez, A., Costa, G., Costa, M. J., Costanzo, D., Cottin, G., Cowan, G., Cox, B. E., Cranmer, K., Crawley, S. J., Creager, R. A., Cree, G., Crépé-Renaudin, S., Crescioli, F., Cribbs, W. A., Cristinziani, M., Croft, V., Crosetti, G., Cueto, A., Cuhadar Donszelmann, T., Cukierman, A. R., Cummings, J., Curatolo, M., Cãºth, J., Czekierda, S., Czodrowski, P., D'Amen, G., D'Auria, S., D'Eramo, L., D'Onofrio, M., Da Cunha Sargedas De Sousa, M. J., Da Via, C., Dabrowski, W., Dado, T., Dai, T., Dale, O., Dallaire, F., Dallapiccola, C., Dam, M., Dandoy, J. R., Daneri, M. F., Dang, N. P., Daniells, A. C., Dann, N. S., Danninger, M., Dano Hoffmann, M., Dao, V., Darbo, G., Darmora, S., Dassoulas, J., Dattagupta, A., Daubney, T., Davey, W., David, C., Davidek, T., Davis, D. R., Davison, P., Dawe, E., Dawson, I., De, K., de Asmundis, R., De Benedetti, A., De Castro, S., De Cecco, S., De Groot, N., de Jong, P., De la Torre, H., De Lorenzi, F., De Maria, A., De Pedis, D., De Salvo, A., De Sanctis, U., De Santo, A., De Vasconcelos Corga, K., De Vivie De Regie, J. B., Debbe, R., Debenedetti, C., Dedovich, D. V., Dehghanian, N., Deigaard, I., Del Gaudio, M., Del Peso, J., Delgove, D., Deliot, F., Delitzsch, C. M., Dell'Acqua, A., Dell'Asta, L., Dell'Orso, M., Della Pietra, M., della Volpe, D., Delmastro, M., Delporte, C., Delsart, P. A., Demarco, D. A., Demers, S., Demichev, M., Demilly, A., Denisov, S. P., Denysiuk, D., Derendarz, D., Derkaoui, J. E., Derue, F., Dervan, P., Desch, K., Deterre, C., Dette, K., Devesa, M. R., Deviveiros, P. O., Dewhurst, A., Dhaliwal, S., Di Bello, F. A., Di Ciaccio, A., Di Ciaccio, L., Di Clemente, W. K., Di Donato, C., Di Girolamo, A., Di Girolamo, B., Di Micco, B., Di Nardo, R., Di Petrillo, K. F., Di Simone, A., Di Sipio, R., Di Valentino, D., Diaconu, C., Diamond, M., Dias, F. A., Diaz, M. A., Diehl, E. B., Dietrich, J., DÃez Cornell, S., Dimitrievska, A., Dingfelder, J., Dita, P., Dita, S., Dittus, F., Djama, F., Djobava, T., Djuvsland, J. I., do Vale, M. A. B., Dobos, D., Dobre, M., Dodsworth, D., Doglioni, C., Dolejsi, J., Dolezal, Z., Donadelli, M., Donati, S., Dondero, P., Donini, J., Dopke, J., Doria, A., Dova, M. T., Doyle, A. T., Drechsler, E., Dris, M., Du, Y., Duarte-Campderros, J., Dubreuil, A., Duchovni, E., Duckeck, G., Ducourthial, A., Ducu, O. A., Duda, D., Dudarev, A., Chr Dudder, A., Duffield, E. M., Duflot, L., Dã¼hrssen, M., Dulsen, C., Dumancic, M., Dumitriu, A. E., Duncan, A. K., Dunford, M., Duperrin, A., Duran Yildiz, H., Dã¼ren, M., Durglishvili, A., Duschinger, D., Dutta, B., Duvnjak, D., Dyndal, M., Dziedzic, B. S., Eckardt, C., Ecker, K. M., Edgar, R. C., Eifert, T., Eigen, G., Einsweiler, K., Ekelof, T., El Kacimi, M., El Kosseifi, R., Ellajosyula, V., Ellert, M., Elles, S., Ellinghaus, F., Elliot, A. A., Ellis, N., Elmsheuser, J., Elsing, M., Emeliyanov, D., Enari, Y., Endner, O. C., Ennis, J. S., Epland, M. B., Erdmann, J., Ereditato, A., Ernst, M., Errede, S., Escalier, M., Escobar, C., Esposito, B., Estrada Pastor, O., Etienvre, A. I., Etzion, E., Evans, H., Ezhilov, A., Ezzi, M., Fabbri, F., Fabbri, L., Fabiani, V., Facini, G., Fakhrutdinov, R. M., Falciano, S., Falla, R. J., Faltova, J., Fang, Y., Fanti, M., Farbin, A., Farilla, A., Farina, C., Farina, E. M., Farooque, T., Farrell, S., Farrington, S. M., Farthouat, P., Fassi, F., Fassnacht, P., Fassouliotis, D., Faucci Giannelli, M., Favareto, A., Fawcett, W. J., Fayard, L., Fedin, O. L., Fedorko, W., Feigl, S., Feligioni, L., Feng, C., Feng, E. J., Fenton, M. J., Fenyuk, A. B., Feremenga, L., Fernandez Martinez, P., Fernandez Perez, S., Ferrando, J., Ferrari, A., Ferrari, P., Ferrari, R., Ferreira de Lima, D. E., Ferrer, A., Ferrere, D., Ferretti, C., Fiedler, F., Filipäiä, A., Filipuzzi, M., Filthaut, F., Fincke-Keeler, M., Finelli, K. D., Fiolhais, M. C. N., Fiorini, L., Fischer, A., Fischer, C., Fischer, J., Fisher, W. C., Flaschel, N., Fleck, I., Fleischmann, P., Fletcher, R. R. M., Flick, T., Flierl, B. M., Flores Castillo, L. R., Flowerdew, M. J., Forcolin, G. T., Formica, A., Fã¶rster, F. A., Forti, A., Foster, A. G., Fournier, D., Fox, H., Fracchia, S., Francavilla, P., Franchini, M., Franchino, S., Francis, D., Franconi, L., Franklin, M., Frate, M., Fraternali, M., Freeborn, D., Fressard-Batraneanu, S. M., Freund, B., Froidevaux, D., Frost, J. A., Fukunaga, C., Fusayasu, T., Fuster, J., Gabizon, O., Gabrielli, A., Gach, G. P., Gadatsch, S., Gadomski, S., Gagliardi, G., Gagnon, L. G., Galea, C., Galhardo, B., Gallas, E. J., Gallop, B. J., Gallus, P., Galster, G., Gan, K. K., Ganguly, S., Gao, Y., Gao, Y. S., Garay Walls, F. M., Garcãa, C., GarcÃa Navarro, J. E., GarcÃa Pascual, J. A., Garcia-Sciveres, M., Gardner, R. W., Garelli, N., Garonne, V., Gascon Bravo, A., Gasnikova, K., Gatti, C., Gaudiello, A., Gaudio, G., Gavrilenko, I. L., Gay, C., Gaycken, G., Gazis, E. N., Gee, C. N. 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Nuclear and High Energy Physics ,Settore FIS/01 - Fisica Sperimentale ,High Energy Physics::Phenomenology ,High Energy Physics::Experiment ,lcsh:Physics ,lcsh:QC1-999 - Abstract
Narrow resonances decaying into WW, WZ or ZZ boson pairs are searched for in 36.7 fbâ1of protonâproton collision data at a centre-of-mass energy of s=13 TeV recorded with the ATLAS detector at the Large Hadron Collider in 2015 and 2016. The diboson system is reconstructed using pairs of large-radius jets with high transverse momentum and tagged as compatible with the hadronic decay of high-momentum W or Z bosons, using jet mass and substructure properties. The search is sensitive to diboson resonances with masses in the range 1.2â5.0 TeV. No significant excess is observed in any signal region. Exclusion limits are set at the 95% confidence level on the production cross section times branching ratio to dibosons for a range of theories beyond the Standard Model. Model-dependent lower limits on the mass of new gauge bosons are set, with the highest limit set at 3.5 TeV in the context of mass-degenerate resonances that couple predominantly to bosons.
- Published
- 2018
21. Search for new phenomena in high-mass diphoton final states using 37 fbâ1of protonâproton collisions collected at s=13 TeV with the ATLAS detector
- Author
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M. Aaboud, G. Aad, B. Abbott, O. Abdinov, B. Abeloos, S. H. Abidi, O. S. AbouZeid, N. L. Abraham, H. Abramowicz, H. Abreu, R. Abreu, Y. Abulaiti, B. S. Acharya, S. Adachi, L. Adamczyk, J. Adelman, M. Adersberger, T. Adye, A. A. Affolder, Y. Afik, T. Agatonovic-Jovin, C. Agheorghiesei, J. A. Aguilar-Saavedra, S. P. Ahlen, F. Ahmadov, G. Aielli, S. Akatsuka, H. Akerstedt, T. P. A. Åkesson, E. Akilli, A. V. Akimov, G. L. Alberghi, J. Albert, P. Albicocco, M. J. Alconada Verzini, S. C. Alderweireldt, M. Aleksa, I. N. Aleksandrov, C. Alexa, G. Alexander, T. Alexopoulos, M. Alhroob, B. Ali, M. Aliev, G. Alimonti, J. Alison, S. P. Alkire, B. M. M. Allbrooke, B. W. Allen, P. P. Allport, A. Aloisio, A. Alonso, F. Alonso, C. Alpigiani, A. A. Alshehri, M. I. Alstaty, B. Alvarez Gonzalez, D. Álvarez Piqueras, M. G. Alviggi, B. T. Amadio, Y. Amaral Coutinho, C. Amelung, D. Amidei, S. P. Amor Dos Santos, S. Amoroso, G. Amundsen, C. Anastopoulos, L. S. Ancu, N. Andari, T. Andeen, C. F. Anders, J. K. 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Rutherfoord, N. Ruthmann, Y.F. Ryabov, M. Rybar, G. Rybkin, S. Ryu, A. Ryzhov, G.F. Rzehorz, A.F. Saavedra, G. Sabato, S. Sacerdoti, H.F-W. Sadrozinski, R. Sadykov, F. Safai Tehrani, P. Saha, M. Sahinsoy, M. Saimpert, M. Saito, T. Saito, H. Sakamoto, Y. Sakurai, G. Salamanna, J.E. Salazar Loyola, D. Salek, P.H. Sales De Bruin, D. Salihagic, A. Salnikov, J. Salt, D. Salvatore, F. Salvatore, A. Salvucci, A. Salzburger, D. Sammel, D. Sampsonidis, D. Sampsonidou, J. Sánchez, V. Sanchez Martinez, A. Sanchez Pineda, H. Sandaker, R.L. Sandbach, C.O. Sander, M. Sandhoff, C. Sandoval, D.P.C. Sankey, M. Sannino, Y. Sano, A. Sansoni, C. Santoni, H. Santos, I. Santoyo Castillo, A. Sapronov, J.G. Saraiva, B. Sarrazin, O. Sasaki, K. Sato, E. Sauvan, G. Savage, P. Savard, N. Savic, C. Sawyer, L. Sawyer, J. Saxon, C. Sbarra, A. Sbrizzi, T. Scanlon, D.A. Scannicchio, J. Schaarschmidt, P. Schacht, B.M. Schachtner, D. Schaefer, L. Schaefer, R. Schaefer, J. Schaeffer, S. Schaepe, S. Schaetzel, U. Schäfer, A.C. Schaffer, D. Schaile, R.D. Schamberger, V.A. Schegelsky, D. Scheirich, M. Schernau, C. Schiavi, S. Schier, L.K. Schildgen, C. Schillo, M. Schioppa, S. Schlenker, K.R. Schmidt-Sommerfeld, K. Schmieden, C. Schmitt, S. Schmitt, S. Schmitz, U. Schnoor, L. Schoeffel, A. Schoening, B.D. Schoenrock, E. Schopf, M. Schott, J.F.P. Schouwenberg, J. Schovancova, S. Schramm, N. Schuh, A. Schulte, M.J. Schultens, H.-C. Schultz-Coulon, H. Schulz, M. Schumacher, B.A. Schumm, Ph. Schune, A. Schwartzman, T.A. Schwarz, H. Schweiger, Ph. Schwemling, R. Schwienhorst, J. Schwindling, A. Sciandra, G. Sciolla, M. Scornajenghi, F. Scuri, F. Scutti, J. Searcy, P. Seema, S.C. Seidel, A. Seiden, J.M. Seixas, G. Sekhniaidze, K. Sekhon, S.J. Sekula, N. Semprini-Cesari, S. Senkin, C. Serfon, L. Serin, L. Serkin, M. Sessa, R. Seuster, H. Severini, T. Sfiligoj, F. Sforza, A. Sfyrla, E. Shabalina, N.W. Shaikh, L.Y. Shan, R. Shang, J.T. Shank, M. Shapiro, P.B. Shatalov, K. Shaw, S.M. Shaw, A. 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Solodkov, A. Soloshenko, O.V. Solovyanov, V. Solovyev, P. Sommer, H. Son, A. Sopczak, D. Sosa, C.L. Sotiropoulou, S. Sottocornola, R. Soualah, A.M. Soukharev, D. South, B.C. Sowden, S. Spagnolo, M. Spalla, M. Spangenberg, F. Spanò, D. Sperlich, F. Spettel, T.M. Spieker, R. Spighi, G. Spigo, L.A. Spiller, M. Spousta, R.D. St. Denis, A. Stabile, R. Stamen, S. Stamm, E. Stanecka, R.W. Stanek, C. Stanescu, M.M. Stanitzki, B.S. Stapf, S. Stapnes, E.A. Starchenko, G.H. Stark, J. Stark, S.H Stark, P. Staroba, P. Starovoitov, S. Stärz, R. Staszewski, M. Stegler, P. Steinberg, B. Stelzer, H.J. Stelzer, O. Stelzer-Chilton, H. Stenzel, G.A. Stewart, M.C. Stockton, M. Stoebe, G. Stoicea, P. Stolte, S. Stonjek, A.R. Stradling, A. Straessner, M.E. Stramaglia, J. Strandberg, S. Strandberg, M. Strauss, P. Strizenec, R. Ströhmer, D.M. Strom, R. Stroynowski, A. Strubig, S.A. Stucci, B. Stugu, N.A. Styles, D. Su, J. Su, S. Suchek, Y. Sugaya, M. Suk, V.V. Sulin, DMS Sultan, S. Sultansoy, T. Sumida, S. Sun, X. Sun, K. Suruliz, C.J.E. Suster, M.R. Sutton, S. Suzuki, M. Svatos, M. Swiatlowski, S.P. Swift, I. Sykora, T. Sykora, D. Ta, K. Tackmann, J. Taenzer, A. Taffard, R. Tafirout, E. Tahirovic, N. Taiblum, H. Takai, R. Takashima, E.H. Takasugi, K. Takeda, T. Takeshita, Y. Takubo, M. Talby, A.A. Talyshev, J. Tanaka, M. Tanaka, R. Tanaka, S. Tanaka, R. Tanioka, B.B. Tannenwald, S. Tapia Araya, S. Tapprogge, S. Tarem, G.F. Tartarelli, P. Tas, M. Tasevsky, T. Tashiro, E. Tassi, A. Tavares Delgado, Y. Tayalati, A.C. Taylor, A.J. Taylor, G.N. Taylor, P.T.E. Taylor, W. Taylor, P. Teixeira-Dias, D. Temple, H. Ten Kate, P.K. Teng, J.J. Teoh, F. Tepel, S. Terada, K. Terashi, J. Terron, S. Terzo, M. Testa, R.J. Teuscher, T. Theveneaux-Pelzer, F. Thiele, J.P. Thomas, J. Thomas-Wilsker, P.D. Thompson, A.S. Thompson, L.A. Thomsen, E. Thomson, Y. Tian, M.J. Tibbetts, R.E. Ticse Torres, V.O. Tikhomirov, Yu.A. Tikhonov, S. Timoshenko, P. Tipton, S. Tisserant, K. Todome, S. Todorova-Nova, S. Todt, J. Tojo, S. Tokár, K. Tokushuku, E. Tolley, L. Tomlinson, M. Tomoto, L. Tompkins, K. Toms, B. Tong, P. Tornambe, E. Torrence, H. Torres, E. Torró Pastor, J. Toth, F. Touchard, D.R. Tovey, C.J. Treado, T. Trefzger, F. Tresoldi, A. Tricoli, I.M. Trigger, S. Trincaz-Duvoid, M.F. Tripiana, W. Trischuk, B. Trocmé, A. Trofymov, C. Troncon, M. Trottier-McDonald, M. Trovatelli, L. Truong, M. Trzebinski, A. Trzupek, K.W. Tsang, J.C-L. Tseng, P.V. Tsiareshka, G. Tsipolitis, N. Tsirintanis, S. Tsiskaridze, V. Tsiskaridze, E.G. Tskhadadze, I.I. Tsukerman, V. Tsulaia, S. Tsuno, D. Tsybychev, Y. Tu, A. Tudorache, V. Tudorache, T.T. Tulbure, A.N. Tuna, S. Turchikhin, D. Turgeman, I. Turk Cakir, R. Turra, P.M. Tuts, G. Ucchielli, I. Ueda, M. Ughetto, F. Ukegawa, G. Unal, A. Undrus, G. Unel, F.C. Ungaro, Y. Unno, K. Uno, C. Unverdorben, J. Urban, P. Urquijo, P. Urrejola, G. Usai, J. Usui, L. Vacavant, V. Vacek, B. Vachon, K.O.H. Vadla, A. Vaidya, C. Valderanis, E. Valdes Santurio, M. Valente, S. Valentinetti, A. Valero, L. Valéry, S. Valkar, A. Vallier, J.A. Valls Ferrer, W. Van Den Wollenberg, H. van der Graaf, P. van Gemmeren, J. Van Nieuwkoop, I. van Vulpen, M.C. van Woerden, M. Vanadia, W. Vandelli, A. Vaniachine, P. Vankov, G. Vardanyan, R. Vari, E.W. Varnes, C. Varni, T. Varol, D. Varouchas, A. Vartapetian, K.E. Varvell, J.G. Vasquez, G.A. Vasquez, F. Vazeille, D. Vazquez Furelos, T. Vazquez Schroeder, J. Veatch, V. Veeraraghavan, L.M. Veloce, F. Veloso, S. Veneziano, A. Ventura, M. Venturi, N. Venturi, A. Venturini, V. Vercesi, M. Verducci, W. Verkerke, A.T. Vermeulen, J.C. Vermeulen, M.C. Vetterli, N. Viaux Maira, O. Viazlo, I. Vichou, T. Vickey, O.E. Vickey Boeriu, G.H.A. Viehhauser, S. Viel, L. Vigani, M. Villa, M. Villaplana Perez, E. Vilucchi, M.G. Vincter, V.B. Vinogradov, A. Vishwakarma, C. Vittori, I. Vivarelli, S. Vlachos, M. Vogel, P. Vokac, G. Volpi, H. von der Schmitt, E. von Toerne, V. Vorobel, K. Vorobev, M. Vos, R. Voss, J.H. Vossebeld, N. Vranjes, M. Vranjes Milosavljevic, V. Vrba, M. Vreeswijk, R. Vuillermet, I. Vukotic, P. Wagner, W. Wagner, J. Wagner-Kuhr, H. Wahlberg, S. Wahrmund, J. Walder, R. Walker, W. Walkowiak, V. Wallangen, C. Wang, C. Wang, F. Wang, H. Wang, H. Wang, J. Wang, J. Wang, Q. Wang, R.-J. Wang, R. Wang, S.M. Wang, T. Wang, W. Wang, W. Wang, Z. Wang, C. Wanotayaroj, A. Warburton, C.P. Ward, D.R. Wardrope, A. Washbrook, P.M. Watkins, A.T. Watson, M.F. Watson, G. Watts, S. Watts, B.M. Waugh, A.F. Webb, S. Webb, M.S. Weber, S.M. Weber, S.W. Weber, S.A. Weber, J.S. Webster, A.R. Weidberg, B. Weinert, J. Weingarten, M. Weirich, C. Weiser, H. Weits, P.S. Wells, T. Wenaus, T. Wengler, S. Wenig, N. Wermes, M.D. Werner, P. Werner, M. Wessels, T.D. Weston, K. Whalen, N.L. Whallon, A.M. Wharton, A.S. White, A. White, M.J. White, R. White, D. Whiteson, B.W. Whitmore, F.J. Wickens, W. Wiedenmann, M. Wielers, C. Wiglesworth, L.A.M. Wiik-Fuchs, A. Wildauer, F. Wilk, H.G. Wilkens, H.H. Williams, S. Williams, C. Willis, S. Willocq, J.A. Wilson, I. Wingerter-Seez, E. Winkels, F. Winklmeier, O.J. Winston, B.T. Winter, M. Wittgen, M. Wobisch, T.M.H. Wolf, R. Wolff, M.W. Wolter, H. Wolters, V.W.S. Wong, N.L. Woods, S.D. Worm, B.K. Wosiek, J. Wotschack, K.W. Wozniak, M. Wu, S.L. Wu, X. Wu, Y. Wu, T.R. Wyatt, B.M. Wynne, S. Xella, Z. Xi, L. Xia, D. Xu, L. Xu, T. Xu, B. Yabsley, S. Yacoob, D. Yamaguchi, Y. Yamaguchi, A. Yamamoto, S. Yamamoto, T. Yamanaka, F. Yamane, M. Yamatani, Y. Yamazaki, Z. Yan, H. Yang, H. Yang, Y. Yang, Z. Yang, W-M. Yao, Y.C. Yap, Y. Yasu, E. Yatsenko, K.H. Yau Wong, J. Ye, S. Ye, I. Yeletskikh, E. Yigitbasi, E. Yildirim, K. Yorita, K. Yoshihara, C. Young, C.J.S. Young, J. Yu, J. Yu, S.P.Y. Yuen, I. Yusuff, B. Zabinski, G. Zacharis, R. Zaidan, A.M. Zaitsev, N. Zakharchuk, J. Zalieckas, A. Zaman, S. Zambito, D. Zanzi, C. Zeitnitz, G. Zemaityte, A. Zemla, J.C. Zeng, Q. Zeng, O. Zenin, T. Ženiš, D. Zerwas, D. Zhang, D. Zhang, F. Zhang, G. Zhang, H. Zhang, J. Zhang, L. Zhang, L. Zhang, M. Zhang, P. Zhang, R. Zhang, R. Zhang, X. Zhang, Y. Zhang, Z. Zhang, X. Zhao, Y. Zhao, Z. Zhao, A. Zhemchugov, B. Zhou, C. Zhou, L. Zhou, M. Zhou, M. Zhou, N. Zhou, Y. Zhou, C.G. Zhu, H. Zhu, J. Zhu, Y. Zhu, X. Zhuang, K. Zhukov, A. Zibell, D. Zieminska, N.I. Zimine, C. Zimmermann, S. Zimmermann, Z. Zinonos, M. Zinser, M. Ziolkowski, L. Živković, G. Zobernig, A. Zoccoli, R. Zou, M. zur Nedden, L. Zwalinski
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Nuclear and High Energy Physics - Abstract
Searches for new phenomena in high-mass diphoton final states with the ATLAS experiment at the LHC are presented. The analysis is based on pp collision data corresponding to an integrated luminosity of 36.7 fbâ1at a centre-of-mass energy s=13 TeV recorded in 2015 and 2016. Searches are performed for resonances with spin 0, as predicted by theories with an extended Higgs sector, and for resonances with spin 2, using a warped extra-dimension model as a benchmark model, as well as for non-resonant signals, assuming a large extra-dimension scenario. No significant deviation from the Standard Model is observed. Upper limits are placed on the production cross section times branching ratio to two photons as a function of the resonance mass. In addition, lower limits are set on the ultraviolet cutoff scale in the large extra-dimensions model.
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- 2017
22. Association Between Direct Oral Anticoagulant Score and Bleeding Events in Patients With Atrial Fibrillation Following Transcatheter Aortic Valve Replacement: A Retrospective Multicenter Cohort Study.
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Harano Y, Yamamoto M, Shimura T, Okubo M, Koyama Y, Yamaguchi R, Kagase A, Tokuda T, Yashima F, Shirai S, Tada N, Naganuma T, Yamawaki M, Yamanaka F, Mizutani K, Noguchi M, Ueno H, Takagi K, Ohno Y, Izumo M, Nishina H, Asami M, Otsuka T, Watanabe Y, and Hayashida K
- Abstract
Background: The Direct Oral Anticoagulant (DOAC) Score can predict bleeding risk in patients with atrial fibrillation taking DOACs; however, it lacks external validation. Therefore, this study aimed to assess the association between the DOAC Score and bleeding events in patients with atrial fibrillation who underwent transcatheter aortic valve replacement., Methods and Results: This retrospective multicenter cohort study included patients with atrial fibrillation who underwent transcatheter aortic valve replacement, as registered in a Japanese multicenter registry. The primary end point was the incidence of bleeding. Patients were categorized based on their DOAC Score: low and moderate- (≤7 points), high- (8-9 points), and very high-risk (≥10 points) groups. Among 1230 patients (mean age 84.6±5.1 years; 457 men), 465 (37.8%) received a vitamin K antagonist, and the remaining patients received DOACs. The low and moderate-, high-, and very high-risk groups included 380 (30.1%), 497 (40.4%), and 353 patients (28.7%), respectively. The 3-year cumulative incidence of all bleeding events was significantly different among the 3 groups (low and moderate risk: 6.6%, high risk: 6.9%, and very high risk: 14.0%; P <0.01). Multivariable Cox regression analysis revealed that significant increments in the DOAC Score were associated with a risk of all bleeding events at 3 years in the overall cohort (hazard ratio [HR], 1.22 [95% CI, 1.08-1.38]; P <0.01), in the DOAC cohort (HR, 1.20 [95% CI, 1.01-1.42]; P =0.04), and in the vitamin K antagonist cohort (HR, 1.25 [95% CI, 1.04-1.50]; P =0.02)., Conclusions: The DOAC Score was significantly associated with bleeding events in patients with atrial fibrillation after transcatheter aortic valve replacement, aiding in clinical decision-making for anticoagulant management., Registration: URL: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000023585; Unique identifier: UMIN000020423.
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- 2024
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23. Initial Findings Concerning the Latest Self-expandable Evolut FX Valve: A Report Using OCEAN-TAVI Registry Data.
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Yashima F, Yamamoto M, Shirai S, Tada N, Naganuma T, Yamawaki M, Yamanaka F, Mizutani K, Noguchi M, Ueno H, Takagi K, Ohno Y, Izumo M, Nishina H, Suzuyama H, Yamasaki K, Nishioka K, Hachinohe D, Fuku Y, Otsuka T, Asami M, Watanabe Y, and Hayashida K
- Abstract
Data concerning the clinical effect of the latest-generation self-expandable transcatheter heart valve (Evolut FX) remain limited. We aimed to assess the in-hospital outcomes of 3 bioprosthetic valves (Evolut EPO, PRO+, and FX). We analyzed data from a Japanese multicenter registry involving 634 consecutive patients who underwent transcatheter aortic valve replacement (TAVR) with Evolut FX up until October 2023. Patients who underwent TAVR with Evolut EPO between 2018 and 2020 (n = 1128), and those with Evolut EPO+ between 2020 and 2023 (n = 1696) served as control groups. Exclusion criteria comprised patients on dialysis, with a history of infective endocarditis, or with insufficient data. Unmatched comparisons among the 3 valves were conducted, followed by a propensity score (PS)-matched comparison between Evolut EPO+ and FX. In the unmatched cohort, among the Evolut EPO, PRO+, and FX groups, all vascular complications (7.8% vs. 5.2% vs. 4.5%, respectively; p < 0.01) and new pacemaker implantation (PMI) rates (11.2% vs. 6.1% vs. 7.7%, respectively; p < 0.01) differed significantly. In the PS-matched analysis, the rate of all bleeding events was significantly higher in the Evolut EPO+ group (11.0%) than in the FX group (7.0%) (p = 0.02), while all vascular complications (4.6% vs. 4.6%, respectively; p = 1.00) and new PMI (5.9% vs. 7.6%, respectively; p = 0.28) rates were comparable. The incidence of stroke in the FX group was approximately half that of the EP+ group (3.7% vs. 1.9%, p = 0.095) without statistical significance. In conclusion, compared with Evolut EPO+, Evolut FX was associated with a lower incidence of in-hospital bleeding complications and may reduce an in-hospital stroke incidence., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The OCEAN-TAVI registry reports financial support was provided by Edwards Life Sciences, Medtronic, Boston Scientific, Abbott Medical, and Daiichi-Sankyo. Fumiaki Yashima reports a relationship with Medtronic that includes: consulting or advisory. Kenji Nishioka reports a relationship with Edwards Lifesciences Corporation that includes: consulting or advisory. Masaki Izumo reports a relationship with Edwards Lifesciences Corporation that includes: consulting or advisory. Yohei Ohno reports a relationship with Medtronic that includes: consulting or advisory. Masahiko Asami reports a relationship with Medtronic that includes: consulting or advisory. Hidetaka Nishina reports a relationship with Medtronic that includes: consulting or advisory. Toru Naganuma reports a relationship with Edwards Lifesciences Corporation and Medtronic that includes: consulting or advisory. Kazuki Mizutani reports a relationship with Edwards Lifesciences Corporation and Medtronic that includes: consulting or advisory. Hiroshi Ueno reports a relationship with Edwards Lifesciences Corporation and Medtronic that includes: consulting or advisory. Yasushi Fuku reports a relationship with Edwards Lifesciences Corporation and Medtronic that includes: consulting or advisory. Kensuke Takagi reports a relationship with Edwards Lifesciences Corporation and Medtronic that includes: consulting or advisory. Masanori Yamamoto reports a relationship with Edwards Lifesciences Corporation, Abbott Medical, and Medtronic that includes: consulting or advisory. Shinichi Shirai reports a relationship with Edwards Lifesciences Corporation, Abbott Medical, and Medtronic that includes: consulting or advisory. Norio Tada reports a relationship with Edwards Lifesciences Corporation, Abbott Medical, and Medtronic that includes: consulting or advisory. Kazumasa Yamasaki reports a relationship with Edwards Lifesciences Corporation, Abbott Medical, and Medtronic that includes: consulting or advisory. Daisuke Hachinohe reports a relationship with Edwards Lifesciences Corporation, Abbott Medical, and Medtronic that includes: consulting or advisory. Yusuke Watanabe reports a relationship with Edwards Lifesciences Corporation, Abbott Medical, and Medtronic that includes: consulting or advisory. Kentaro Hayashida reports a relationship with Edwards Lifesciences Corporation, Abbott Medical, and Medtronic that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)
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- 2024
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24. Heatmap analysis for artificial intelligence explainability in diabetic retinopathy detection: illuminating the rationale of deep learning decisions.
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Malerbi FK, Nakayama LF, Prado P, Yamanaka F, Melo GB, Regatieri CV, and Stuchi JA
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Background: The opaqueness of artificial intelligence (AI) algorithms decision processes limit their application in healthcare. Our objective was to explore discrepancies in heatmaps originated from slightly different retinal images from the same eyes of individuals with diabetes, to gain insights into the deep learning (DL) decision process., Methods: Pairs of retinal images from the same eyes of individuals with diabetes, composed of images obtained before and after pupil dilation, underwent automatic analysis by a convolutional neural network for the presence of diabetic retinopathy (DR), output being a score ranging from 0 to 1. Gradient-based Class Activation Maps (GradCam) allowed visualization of activated areas. Pairs of images with discordant DL scores or outputs within the pair were objectively compared to the concordant pairs, regarding the sum of activations of Class Activation Mapping (CAM), the number of activated areas, and DL score differences. Heatmaps of discordant pairs were also qualitatively assessed., Results: Algorithmic performance for the detection of DR attained 89.8% sensitivity, 96.3% specificity and area under the receiver operating characteristic (ROC) curve of 0.95. Out of 210 comparable pairs of images, 20 eyes and 10 eyes were considered discordant according to DL score difference and regarding DL output, respectively. Comparison of concordant versus discordant groups showed statistically significant differences for all objective variables. Qualitative analysis pointed to subtle differences in image quality within discordant pairs., Conclusions: The successfully established relationship among objective parameters extracted from heatmaps and DL output discrepancies reinforces the role of heatmaps for DL explainability, fostering acceptance of DL systems for clinical use., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-24-73/coif). F.K.M. is a consultant for Phelcom Technologies, and has received consulting fees for medical advice and travel support for attending meetings from Phelcom Technologies. P.P. and F.Y. are employees at Phelcom Technologies. G.B.M. has received consulting fees and travel expenses from SJJ Solutions, and has been part of advisory boards for Bayer, Roche, and West Pharmaceuticals. J.A.S. is a founding partner and CEO of Phelcom Technologies, and owns stock or stock options of Phelcom Technologies. The other authors have no conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)
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- 2024
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25. Difference in Cardiac Response after Transcatheter Aortic Valve Implantation according to Flow and Gradient Pattern.
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Yokoyama H, Yamanaka F, Shishido K, Moriyama N, Ochiai T, Miyashita H, Sugiyama Y, Yashima F, Ohno Y, Nishina H, Izumo M, Asami M, Naganuma T, Mizutani K, Yamawaki M, Tada N, Shirai S, Noguchi M, Ueno H, Takagi K, Watanabe Y, Yamamoto M, Saito S, and Hayashida K
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Background: In patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS), data on the differences in subsequent cardiac structure and function among stratified groups with flow gradient patterns through the aortic valve are insufficient., Methods: In this large multicenter study, 4,523 patients undergoing TAVI for severe AS between 2013 and 2019 were divided into 3 groups according to the following criteria: (1) high-gradient AS (HG-AS) (mean pressure gradient [MPG] ≥40 mmHg), (2) classical low-flow low-gradient AS (cLFLG-AS) (MPG <40 mmHg, left ventricular [LV] ejection fraction [LVEF] <50%), and (3) paradoxical low-flow low-gradient AS (pLFLG-AS) (MPG <40 mmHg, LVEF ≥50% but stroke volume index [SVi] <35 mL/m2). Echocardiography was performed at baseline, post-procedure, and 1 year post-TAVI., Results: 3,697, 507, and 319 patients had HG-AS, cLFLG-AS, and pLFLG-AS, respectively. After adjusting for clinical factors, cLFLG-AS and pLFLG-AS had an approximately 1.5-fold higher 2-year all-cause mortality compared with HG-AS. During 1 year following TAVI, compared with HG-AS, cLFLG-AS showed greater reduction of LV systolic diameter (LVDs) and LV diastolic diameter (LVDd) and greater increase of LVEF (p<0.001 for all), and changes in LV mass index (LVMi) and SVi were comparable (p=0.915 and p=0.821, respectively). However, pLFLG-AS demonstrated less reduction of LVDs and LVDd (p=0.039 and p=0.001, respectively), less improvement of LVEF and LVMi (p=0.045 and p<0.001, respectively), and comparable change in SVi (p=0.364)., Conclusions: During 1 year post-TAVI, compared with HG-AS, cLFLG-AS achieves smaller LV diameters, greater increase in LVEF, and comparable regression of LVMi, whereas pLFLG-AS does not., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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26. Transcatheter aortic valve implantation for combined aortic and mitral stenoses: Insights from the OCEAN-TAVI Registry.
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Kato N, Tabata M, Noguchi M, Ito J, Obunai K, Watanabe H, Yashima F, Shirai S, Tada N, Naganuma T, Yamawaki M, Yamanaka F, Ueno H, Ohno Y, Izumo M, Nishina H, Asami M, Watanabe Y, Yamamoto M, Otsuka T, and Hayashida K
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Aims: Mitral stenosis (MS) occasionally coexists with aortic stenosis (AS). Limited data are available regarding the functional class and clinical outcomes of patients who undergo transcatheter aortic valve implantation (TAVI) for combined AS and MS. This study compared the clinical outcomes in patients with and without MS who underwent TAVI for severe AS and assessed the impact of mitral annulus calcification (MAC) severity, transmitral gradient (TMG) and mitral valve area (MVA) on outcomes in patients with combined AS and MS., Methods: We investigated patients in the OCEAN-TAVI registry who underwent TAVI. MS was defined as an MVA ≤ 1.5 cm
2 or TMG ≥ 5 mmHg. The composite of all-cause death and admission for heart failure was compared between patients with and without MS. The impact of MAC, TMG and MVA on outcomes was assessed in patients with combined AS and MS., Results: We identified 106 patients with MS (MAC 84%; TMG 6.4 ± 2.6 mmHg; MVA 1.10 ± 0.31 cm2 ) and 6570 without MS as controls. The MS group was older (85 ± 5 vs. 84 ± 5 years, P = 0.033), more of women (85 vs. 67%, P < 0.01), and had a higher risk of surgery (the Society of Thoracic Surgeons Mortality Score 8.7 ± 5.1 vs. 7.6 ± 5.9, P = 0.047) than the controls. In the MS group, the New York Heart Association Functional Class was 3 or 4 in 56% of the patients at baseline and 6% at 1 year after TAVI. Thirty-day mortality (2.8% vs. 1.3%, P = 0.18) and early composite outcomes (17% vs. 15%, P = 0.56) were comparable between patients with and without MS. During a median follow-up of 2.1 years, the presence of MS was associated with a higher incidence of adverse events compared with controls (adjusted hazard ratio [HR] 1.84; 95% confidence interval [CI] 1.34-2.51, P < 0.01), even on propensity score matched analysis (adjusted HR 1.91; 95% CI 1.14-3.22, P < 0.01). Moderate or severe MAC contributed to increased risk of adverse events in patients with MS (adjusted HR 2.89; 95% CI 1.20-6.99, P = 0.018), but TMG and MVA did not., Conclusions: In patients undergoing TAVI for severe AS, those with moderate or severe MS experienced worse outcomes after TAVI compared with those without MS. Patients with combined AS and MS sustained symptom improvement at 1-year post-TAVI. MAC severity was a useful predictor of adverse events compared with MS haemodynamics such as TMG and MVA in patients with combined AS and MS., (© 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)- Published
- 2024
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27. Transcatheter Aortic Valve Implantation in Japanese Patients With Large Annulus: The OCEAN-TAVI Registry.
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Onishi K, Mizutani K, Fujita K, Ueno M, Sakaguchi G, Nakazawa G, Ohno Y, Yashima F, Naganuma T, Tada N, Shirai S, Yamanaka F, Noguchi M, Izumo M, Takagi K, Asami M, Ueno H, Nishina H, Otsuka T, Watanabe Y, Yamamoto M, and Hayashida K
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Background: East Asians have smaller aortic valve complexes than individuals from Western countries, and few studies have reported transcatheter aortic valve implantation (TAVI) outcomes in Asian patients with a large annulus., Objectives: This study aimed to compare the short- and long-term outcomes of TAVI using balloon-expandable valves (BEVs) and self-expandable valves (SEVs) in Asian patients with a large annulus., Methods: The study retrospectively analyzed the data from the OCEAN-TAVI (Optimized Transcatheter Valvular Intervention Transcatheter Aortic Valve Implantation) registry. A large annulus was defined by an annular area ≥500 mm
2 and an average diameter ≥25 mm as measured by computed tomography. The primary endpoint was 3-year all-cause mortality. Secondary endpoints were 3-year heart failure rehospitalization (HFR) after TAVI, short-term outcomes of TAVI, and changes in valve function 2 years after TAVI., Results: Among 773 patients, 671 underwent BEV TAVI. The SEV TAVI group showed a significantly higher incidence of greater than moderate paravalvular leakage (PVL) ( P < 0.001), and an increased pacemaker implantation rate ( P = 0.035). The incidence of prosthesis-patient mismatch did not differ between the 2 groups. The Kaplan-Meier curve showed no significant differences in 3-year all-cause mortality and HFR rates (log-rank P = 0.900), and echocardiographic valve function at 2 years post-TAVI did not differ between the 2 groups., Conclusions: The lack of differences in postoperative valve performance and long-term prognosis between BEV TAVI and SEV TAVI highlights the importance of selecting valves that can reduce the pacemaker implantation rate and PVL grade in the acute phase in patients with a large annulus. (Optimized Transcatheter Valvular Intervention Transcatheter Aortic Valve Implantation [OCEAN-TAVI]; UMIN000020423)., Competing Interests: The OCEAN-TAVI registry was supported by Edwards Lifesciences, Medtronic, Boston Scientific, Abbott Medical, and Daiichi-Sankyo. Dr Mizutani has served as a clinical proctor for Edwards Lifesciences and Medtronic. Dr Ohno has served as a clinical proctor for Medtronic. Dr Yashima has served as a clinical proctor for Medtronic. Dr Naganuma has served as a clinical proctor for Edwards Lifesciences and Medtronic. Dr Tada has served as a clinical proctor for Edwards Lifesciences and Medtronic. Dr Shirai has served as a clinical proctor for Edwards Lifesciences, Abbott Medical, and Medtronic. Dr Takagi has served as a clinical proctor for Edwards Lifesciences. Dr Asami has served as a clinical proctor for Medtronic. Dr H. Ueno has served as a clinical proctor for Edwards Lifesciences and Medtronic. Dr Watanabe has served as a clinical proctor for Edwards Lifesciences and Medtronic. Dr Yamamoto has served as a clinical proctor for Edwards Lifesciences, Abbott Medical, and Medtronic. Dr Hayashida has served as a clinical proctor for Edwards Lifesciences, Abbott Medical, and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)- Published
- 2024
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28. Long-term prognostic value of the H 2 FPEF score in patients undergoing transcatheter aortic valve implantation.
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Ishizu K, Shirai S, Isotani A, Hayashi M, Tabata H, Ohno N, Kakumoto S, Ando K, Yashima F, Tada N, Yamawaki M, Naganuma T, Yamanaka F, Ueno H, Tabata M, Mizutani K, Takagi K, Watanabe Y, Yamamoto M, and Hayashida K
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- Humans, Female, Male, Aged, 80 and over, Prognosis, Follow-Up Studies, Time Factors, Registries, Heart Failure epidemiology, Japan epidemiology, Survival Rate trends, Retrospective Studies, Risk Factors, Aged, Risk Assessment methods, Transcatheter Aortic Valve Replacement methods, Aortic Valve Stenosis surgery, Stroke Volume physiology
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Aims: A considerable proportion of candidates for transcatheter aortic valve implantation (TAVI) have underlying heart failure (HF) with preserved ejection fraction (HFpEF), which can be challenging for diagnosis because significant valvular heart disease should be excluded before diagnosing HFpEF. This study investigated the long-term prognostic value of the pre-procedural H
2 FPEF score in patients with preserved ejection fraction (EF) undergoing TAVI., Methods and Results: Patients who underwent TAVI between October 2013 and May 2017 were enrolled from the Optimized CathEter vAlvular iNtervention-Transcatheter Aortic Valve Implantation Japanese multicentre registry. After excluding 914 patients, 1674 patients with preserved EF ≥ 50% (median age: 85 years, 72% female) were selected for calculation of the H2 FPEF score and were dichotomized into two groups: the low H2 FPEF score [0-5 points; n = 1399 (83.6%)] group and the high H2 FPEF score [6-9 points; n = 275 (16.4%)] group. Patients with high H2 FPEF scores were associated with a higher prevalence of New York Heart Association Functional Class III/IV (59.3% vs. 43.7%, P < 0.001), diabetes (24.4% vs. 18.5%, P = 0.03), and paradoxical low-flow, low-gradient aortic stenosis (15.9% vs. 6.2%, P < 0.001). These patients showed worse prognoses than those with low H2 FPEF scores regarding the cumulative 2 year all-cause mortality (26.3% vs. 15.5%, log-rank P < 0.001), cardiovascular mortality (10.5% vs. 5.4%, log-rank P < 0.001), HF hospitalization (16.2% vs. 6.7%, log-rank P < 0.001), and the composite endpoint of cardiovascular mortality and HF hospitalization (23.8% vs. 10.8%, log-rank P < 0.001). After adjustment for several confounders, the high H2 FPEF scores were independently associated with increased risk for all-cause mortality [adjusted hazard ratio (HR), 1.48; 95% confidence interval (CI), 1.09-2.00; P = 0.011] and for the composite endpoint of cardiovascular mortality and HF hospitalization (adjusted HR, 1.95; 95% CI, 1.38-2.74; P < 0.001). Subgroup analysis confirmed the excess risk of high H2 FPEF scores relative to low H2 FPEF scores for the composite endpoint of cardiovascular mortality and HF hospitalization increased with a lower Society of Thoracic Surgeons (STS) score (STS score <8%: adjusted HR, 2.40; 95% CI, 1.50-3.85; P < 0.001; STS score ≥8%: adjusted HR, 1.34; 95% CI, 0.79-2.28; P = 0.28; Pinteraction = 0.030)., Conclusions: The H2 FPEF score is useful for predicting long-term adverse outcomes after TAVI, including all-cause mortality, cardiovascular mortality, and HF hospitalization for patients with preserved EF. More aggressive interventions targeting HFpEF in addition to the TAVI procedure might be relevant in patients with high H2 FPEF scores, particularly in those with a lower surgical risk., (© 2024 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)- Published
- 2024
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29. Size of Self-Expandable Transcatheter Heart Valve and Mid-Term Adverse Events After Transcatheter Aortic Valve Replacement.
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Hioki H, Yamamoto M, Watanabe Y, Ohno Y, Yashima F, Naganuma T, Tada N, Shirai S, Yamanaka F, Mizutani K, Noguchi M, Izumo M, Takagi K, Asami M, Ueno H, Nishina H, Otsuka T, and Hayashida K
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- Aged, Aged, 80 and over, Female, Humans, Male, Aortic Valve surgery, Cause of Death trends, Follow-Up Studies, Heart Failure, Incidence, Propensity Score, Retrospective Studies, Risk Factors, Treatment Outcome, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Postoperative Complications epidemiology, Prosthesis Design, Transcatheter Aortic Valve Replacement adverse effects
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The hemodynamic performance of self-expandable valves (SEVs) is a preferable choice for small aortic annuli in transcatheter aortic valve replacement (TAVR). However, no data are, so far, available regarding the relation between the size of SEVs and clinical outcomes. This study aimed to evaluate the impact of prosthesis size on adverse events after TAVR using SEVs. We retrospectively analyzed 1,400 patients (23-mm SEV: 13.6%) who underwent TAVR using SEVs at 12 centers. The impact of SEV size on all-cause death and heart failure (HF) after TAVR was evaluated by multivariate Cox regression and propensity score (PS) matching analysis. During the follow-up period (median 511 days), 201 all-cause deaths and 87 HF rehospitalizations were observed. The incidence of all-cause death was comparable between small- (23-mm SEV) and larger-sized (26- or 29-mm SEV) (16.8% vs 13.9%, log-rank p = 0.29). The size of SEV was not associated with a higher incidence of all-cause death (hazard ratio [HR] 1.21, 95% confidence interval [CI] 0.79 to 1.86 in Cox regression; HR 1.31, 95% CI 0.77 to 2.23 in PS matching) and HF after TAVR (subdistribution HR 0.79, 95% CI 0.37 to 1.72 in Cox regression; subdistribution HR 1.00, 95% CI 0.44 to 2.30 in PS matching). The multivariate model including postprocedural prosthesis-patient mismatch showed consistent results. In conclusion, small SEVs had comparable midterm clinical outcomes to larger-sized SEVs, even if the prosthesis-patient mismatch was observed after TAVR., Competing Interests: Declaration of competing interest Dr. Takagi is a clinical proctor for Edwards Lifesciences. Drs. Yashima, Ohno, and Asami are clinical proctors for Medtronic. Drs. Naganuma, Mizutani, Tada, Ueno, and Watanabe are clinical proctors for Edwards Lifesciences and Medtronic. Drs. Yamamoto, Shirai, and Hayashida served as clinical proctors for Edwards Lifesciences, Abbott Medical, and Medtronic. The remaining authors have no competing interests to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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30. Haemodynamic and clinical outcomes at 5 years according to predicted prosthesis-patient mismatch after transcatheter aortic valve replacement.
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Sugiyama Y, Miyashita H, Ochiai T, Shishido K, Jalanko M, Yamanaka F, Vähäsilta T, Saito S, Laine M, and Moriyama N
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Background/purpose: Although the impact of predicted prosthesis-patient mismatch (PPM
P ) on outcomes after surgical aortic valve replacement is well established, studies on PPMP in transcatheter aortic valve replacement (TAVR) are limited. This study investigated the effects of PPMp on haemodynamic and 5-year clinical outcomes after TAVR., Methods/materials: We analysed 1733 patients who underwent TAVR. PPMp was defined using two different methods: 1) normal reference values of the effective orifice area for each valve type and size indexed to body surface area (PPMp1 ; n = 1733) and 2) reference values for aortic annulus area or perimeter assessed with pre-procedural computed tomography indexed to body surface area (PPMp2 ; n = 1227). The primary endpoint was the composite of all-cause death and/or rehospitalisation for heart failure at 5 years., Results: The incidence of PPMp1 was 11.7 % and 0.8 % in moderate and severe cases, respectively. PPMp2 was classified as either moderate (3.8 %) or severe (0 %). Rates of residual mean aortic gradient ≥20 mmHg significantly increased depending on PPMp1 severity (no PPMp1 : 3.1 % vs. moderate PPMp1 : 26.8 % vs. severe PPMp1 : 53.9 %, p < 0.0001) and PPMp2 (no PPMp2 : 4.1 % vs. moderate PPMp2 : 12.8 %, p = 0.0049). Neither of PPMP methods were associated with the composite outcome in total cohort; however, PPMP1 was significantly related to worse clinical outcomes at 5 years among patients with reduced left ventricular ejection fraction (LVEF) in multivariate analysis (HR: 1.87; 95 % CI: 1.02-3.43)., Conclusions: The impact of PPMP on TAVR clinical outcomes may not be negligible in patients with low LVEF., Competing Interests: Declaration of competing interest T.O. has received honoraria for lectures from Medtronic. K.S. has received honoraria for lectures from Medtronic. M.J. has received honoraria for lectures from Edwards Lifesciences and Medtronic. T.V. is a clinical proctor of Edwards Lifesciences (SAPIEN). M.L. reports receiving non-regulatory research grants from Teleflex and consultant fees from Boston Scientific, Edwards Lifesciences, and Medtronic. S.S is a clinical proctor of Edwards Lifesciences (SAPIEN), Medtronic (CoreValve) and Abbott (Navitor). N.M. has received honoraria for lectures from Abbott, Edwards Lifesciences, and Medtronic. And N.M. is a clinical proctor of Edwards Lifesciences (SAPIEN) and Boston Scientific (ACURATE neo), and received a research grant from the Japanese Circulation Society. The other authors have no potential conflicts of interest to declare., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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31. Initial Results of Intra-Annular Self-Expandable Valves: Insights From the OCEAN-TAVI Registry.
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Shirai S, Yamamoto M, Yashima F, Hioki H, Ryuzaki T, Morofuji T, Naganuma T, Yamanaka F, Mizutani K, Noguchi M, Ueno H, Takagi K, Ohno Y, Izumo M, Nishina H, Suzuyama H, Yamasaki K, Hachinohe D, Fuku Y, Otsuka T, Asami M, Watanabe Y, and Hayashida K
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Background: Navitor, an intra-annular self-expanding heart valve (IA-SEV), is the third transcatheter heart valve introduced in Japan (in April 2022) as the next generation of the Portico valve ahead of other Asian countries., Objectives: The purpose of this study was to assess the patient-prosthesis mismatch (PPM) after IA-SEV implantation in Asian patients., Methods: All clinical data were collected from the database of an ongoing prospective Japanese multicenter registry (OCEAN-TAVI [Optimised Catheter Valvular Intervention transcatheter aortic valve implantation]). The primary endpoint was the rate of no PPM; the secondary endpoint included the rate of in-hospital mortality and hemodynamics after IA-SEV implantation., Results: A total of 463 patients (median age 86; 69.7% female) were enrolled in the registry. The percentages of implanted valves sized 23 mm, 25 mm, 27 mm, and 29 mm were 26.1% (n = 121), 41.7% (n = 193), 22.9% (n = 106), and 9.3% (n = 43), respectively. The primary endpoint of no PPM was achieved in 91.7% of the entire cohort and in 87.3%, 94.2%, 91.4%, and 93.0% of each valve size. The rate of in-hospital mortality was 1.9%. Postprocedural mean pressure gradient was 8.3 ± 4.3 mm Hg. The overall rate of pacemaker implantation was 9.7%; the incidence of pacemaker rate tended to be reduced when dividing the first and second half of operator experiences (13.0% vs. 8.0%; P = 0.08)., Conclusions: The initial results for the IA-SEV were excellent regarding hemodynamics and reduction of paravalvular leakage regardless of valve size. The IA-SEV is a useful transcatheter heart valve, especially for Asian patients with a high prevalence of small annulus., Competing Interests: The OCEAN-TAVI registry is supported by Edwards Lifesciences, Medtronic, Boston Scientific, Abbott Medical, and Daiichi-Sankyo Company. Drs Takagi and Nishioka are clinical proctors for Edwards Lifesciences. Dr Izumo is a screening proctor for Edwards Lifesciences. Drs Yashima, Ohno, and Asami are clinical proctors for Medtronic. Drs Naganuma, Mizutani, Ueno, and Fuku are clinical proctors for Edwards Lifesciences and Medtronic. Drs Yamamoto, Shirai, Tada, Yamasaki, Hachinohe, Watanabe, and Hayashida are clinical proctors for Edwards Lifesciences, Abbott Medical, and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)
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- 2024
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32. Performance and outcomes of the SAPIEN 3 Ultra RESILIA transcatheter heart valve in the OCEAN-TAVI registry.
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Yamamoto M, Yashima F, Shirai S, Tada N, Naganuma T, Yamawaki M, Yamanaka F, Mizutani K, Noguchi M, Ueno H, Takagi K, Ohno Y, Izumo M, Nishina H, Suzuyama H, Yamasaki K, Nishioka K, Hachinohe D, Fuku Y, Otsuka T, Asami M, Watanabe Y, Hayashida K, and Ocean-Tavi Investigators OBOT
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- Humans, Female, Male, Aged, 80 and over, Aged, Treatment Outcome, Prosthesis Design, Hemodynamics, Postoperative Complications epidemiology, Postoperative Complications etiology, Hospital Mortality, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement instrumentation, Transcatheter Aortic Valve Replacement methods, Registries, Heart Valve Prosthesis, Aortic Valve Stenosis surgery, Aortic Valve Stenosis physiopathology, Aortic Valve surgery, Aortic Valve physiopathology, Aortic Valve diagnostic imaging
- Abstract
Background: Data on the performance of the latest-generation SAPIEN 3 Ultra RESILIA (S3UR) valve in patients who undergo transcatheter aortic valve replacement (TAVR) are scarce., Aims: We aimed to assess the clinical outcomes, including valve performance, of the S3UR., Methods: Registry data of 618 consecutive patients with S3UR and of a historical pooled cohort of 8,750 patients who had a SAPIEN 3 (S3) valve and underwent TAVR were collected. The clinical outcomes and haemodynamics, including patient-prosthesis mismatch (PPM), were compared between the 2 groups and in a propensity-matched cohort., Results: The incidence of in-hospital death, vascular complications, and new pacemaker implantation was similar between the S3UR and the S3 groups (allp>0.05). However, both groups showed significant differences in the degrees of paravalvular leakage (PVL) (none-trivial: 87.0% vs 78.5%, mild: 12.5% vs 20.5%, ≥moderate: 0.5% vs 1.1%; p<0.001) and the incidence of PPM (none: 94.3% vs 85.1%, moderate: 5.2% vs 12.8%, severe: 0.5% vs 2.0%; p<0.001). The prevalence of a mean pressure gradient ≥20 mmHg was significantly lower in the S3UR group (1.6% vs 6.2%; p<0.001). Better haemodynamics were observed with the smaller 20 mm and 23 mm S3UR valves. The results were consistent in a matched cohort of patients with S3UR and with S3 (n=618 patients/group)., Conclusions: The S3UR has equivalent procedural complications to the S3 but with lower rates of PVL and significantly better valve performance. The better valve performance of the S3UR, particularly in smaller valve sizes, overcomes the remaining issue of balloon-expandable valves after TAVR.
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- 2024
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33. Late Sinus Sequestration After TAVR-in-TAVR Rescued by Coronary Artery Bypass Grafting.
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Ochiai T, Yamanaka F, Yamabe T, Miyashita H, Moriyama N, Shishido K, Iwasaki K, and Saito S
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- Humans, Treatment Outcome, Coronary Artery Bypass adverse effects, Aortic Valve diagnostic imaging, Aortic Valve surgery, Risk Factors, Transcatheter Aortic Valve Replacement adverse effects, Aortic Valve Stenosis surgery, Heart Valve Prosthesis
- Abstract
Competing Interests: Funding Support and Author Disclosures Dr Ochiai has received honoraria for lectures from Edwards Lifesciences and Medtronic. Dr Moriyama has received honoraria for lectures from Edwards Lifesciences and Medtronic; and has been a clinical proctor for Edwards Lifesciences and Boston Scientific. Dr Shishido has received honoraria for lectures from Abbott Vascular and Medtronic. Dr Saito is a clinical proctor for Edwards Lifesciences, Medtronic, and Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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- 2024
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34. Long-Term Assessment of Survival After Transcatheter Aortic Valve Implantation - Insights From the International Transcatheter Aortic Valve Implantation Registry.
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Sugiyama Y, Moriyama N, Miyashita H, Yokoyama H, Ochiai T, Shishido K, Jalanko M, Yamanaka F, Vähäsilta T, Laine M, and Saito S
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- Humans, Aged, Aortic Valve surgery, Treatment Outcome, Risk Factors, Registries, Transcatheter Aortic Valve Replacement methods, Aortic Valve Stenosis, Heart Valve Prosthesis Implantation adverse effects
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Background: Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis (AS), but despite estimates of life expectancy after TAVI being essential in heart team discussion, these data are scarce. Therefore, the current study sought to assess long-term survival and its trends in relation to chronological age, surgical risk, and treatment period., Methods and results: We included 2,414 consecutive patients who underwent TAVI for severe symptomatic AS between 2008 and 2021 at 2 international centers. For the analysis, long-term survival was evaluated according to age, surgical risk, and treatment period categorized into 3 groups, respectively. The longest follow-up was 13.5 years. Overall survival was 67.6% at 5 years and 26.9% at 10 years. Younger patients, lower surgical risk, and later treatment period showed better survival (log-rank P<0.001, respectively). In the multivariate analysis, age <75years, lower surgical risk, and later time period were significantly associated with better survival. The incidence of paravalvular leakage ≥moderate, red blood cell transfusion, and acute kidney injury were independently associated with increasing risk of 5-year death., Conclusions: In a real-world registry, survival was substantial following TAVI, especially in younger and lower surgical-risk patients, with improving outcomes over time. This should be considered in heart team discussions of life-long management for AS patients after TAVI.
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- 2024
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35. Sodium-Glucose Cotransporter-2 Inhibitors Stabilize Coronary Plaques in Acute Coronary Syndrome With Diabetes Mellitus.
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Kurozumi A, Shishido K, Yamashita T, Sato D, Uchida S, Koyama E, Tamaki Y, Hayashi T, Miyashita H, Yokoyama H, Ochiai T, Yamaguchi M, Moriyama N, Tobita K, Matsumoto T, Mizuno S, Yamanaka F, Tanaka Y, Murakami M, Takahashi S, and Saito S
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- Humans, Retrospective Studies, Glucose, Lipids, Sodium, Acute Coronary Syndrome complications, Acute Coronary Syndrome drug therapy, Acute Coronary Syndrome epidemiology, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Plaque, Atherosclerotic complications, Plaque, Atherosclerotic diagnostic imaging, Plaque, Atherosclerotic drug therapy
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Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are widely used in cardiology and are effective in treating acute coronary syndrome (ACS). Their effects on unstable plaque in patients with ACS remains unclear. This study aimed to examine the effectiveness of SGLT2is in coronary plaque based on optical coherence tomography (OCT) images and the prognosis of ACS with type 2 diabetes mellitus. This retrospective study included 109 patients in the total cohort and 29 patients in the OCT cohort. Based on SGLT2i administration after ACS, the total cohort was categorized into non-SGLT2i (n = 69) and SGLT2i (n = 40) groups. The OCT cohort had 15 and 14 patients in the non-SGLT2i and SGLT2i groups, respectively. The OCT images of unstable plaque were analyzed in nonstented lesions during ACS catheterization and at the 6-month follow-up. The total cohort was assessed after 1 year for major adverse cardiovascular events, including all-cause mortality, revascularization, cerebrovascular disease, and heart failure hospitalization. SGLT2is improved unstable lesions with a significantly thicker fibrous cap (48 ± 15 μm vs 26 ± 24 μm, p = 0.005), reduced lipid arc (-29 ± 12° vs -18 ± 14°, p = 0.028), higher % decrease in total lipid arc (-35 ± 13% vs -19 ± 18%, p = 0.01), and lower major adverse cardiovascular event incidence (log-rank p = 0.023, hazard ratio 4.72 [1.08 to 20.63]) and revascularization rate (adjusted hazard ratio 6.77 [1.08 to 42.52]) than the non-SGLT2i group. In conclusion, SGLT2is can improve the markers of plaque stability and may improve the prognosis in patients with type 2 diabetes mellitus., Competing Interests: Declaration of competing interest The authors have no competing interest to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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36. Midterm outcomes of transcatheter aortic valve replacement in patients with active cancer.
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Noguchi M, Tabata M, Ito J, Kato N, Obunai K, Watanabe H, Yashima F, Watanabe Y, Naganuma T, Yamawaki M, Yamanaka F, Shirai S, Ueno H, Tada N, Yamamoto M, and Hayashida K
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- Male, Humans, Treatment Outcome, Prospective Studies, Time Factors, Transcatheter Aortic Valve Replacement methods, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Neoplasms diagnosis
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Objectives: The clinical outcomes of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS) and concomitant active cancer remain insufficiently explored. This study aimed to assess the midterm outcomes of TAVR in patients diagnosed with AS and active cancer., Methods: Data from the OCEAN-TAVI, a prospective Japanese registry of TAVR procedures, was analysed to compare prognoses and clinical outcomes in patients with and without active cancer at the time of TAVR., Results: Of the 2336 patients who underwent TAVR from October 2013 to July 2017, 89 patients (3.8%) had active cancer, whereas 2247 did not. Among patients with active cancer, 49 had limited-stage cancer (stage 1 or 2). The prevalent cancers identified before TAVR were colon (21%), prostate (18%), lung (15%), liver (11%) and breast (9%). Although the periprocedural complications and 30-day mortality rates were comparable between the groups, the 3-year survival rate after TAVR was notably lower in patients with active cancer (64.7%) than in those without active cancer (74.7%; p=0.016). Nevertheless, the 3-year survival rate of patients with limited-stage cancer (stage 1 or 2) did not significantly differ from those without cancer (70.6% vs 74.7%, p=0.50)., Conclusions: The patients with active cancer exhibited significantly reduced midterm survival rates. However, no distinct disparity existed in those with limited-stage cancer (stage 1 or 2). Although TAVR is a viable treatment in patients with AS with active cancer, the type and stage of cancer and prognosis should be carefully weighed in the decision-making process., Competing Interests: Competing interests: MT, TN and HU are clinical proctors at Edwards Lifesciences and Medtronic. MY, SS, NT, HW and KH are clinical proctors at Edwards Lifesciences, Abbott Medical and Medtronic. FY is a clinical proctor at Medtronic., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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37. Risk Assessment of Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation in Patients With Preexisting Right Bundle Branch Block.
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Sugiyama Y, Miyashita H, Yokoyama H, Ochiai T, Shishido K, Jalanko M, Yamanaka F, Vähäsilta T, Saito S, Laine M, and Moriyama N
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- Humans, Bundle-Branch Block epidemiology, Bundle-Branch Block therapy, Risk Assessment, Risk Factors, Aortic Valve surgery, Treatment Outcome, Transcatheter Aortic Valve Replacement adverse effects, Pacemaker, Artificial adverse effects, Aortic Valve Stenosis complications, Heart Valve Prosthesis adverse effects
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Preexisting right bundle branch block (RBBB) is the strongest predictor for permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI). However, the risk assessment for new PPI and effective procedural strategy for preventing new PPI in patients with preexisting RBBB are still unclear. This study stratified the new PPI risk after TAVI and investigated the impact of implantation strategy in a preexisting RBBB cohort. We analyzed 237 patients with preexisting RBBB who underwent TAVI. The primary endpoint was the incidence of new PPI. Multivariate analyses investigating predictors for new PPI were performed. The overall PPI rate was 33.3%. Significant baseline predictors for new PPI were combination of RBBB, left anterior or posterior fascicular block, and first-degree atrioventricular block (odds ratio [OR] 2.55, 95% confidence interval [CI] 1.09 to 5.04), high calcium volume of noncoronary cusp (OR 2.08, 95% CI 1.05 to 4.10), and membranous septum (MS) length <2 mm (OR 2.02, 95% CI 1.09 to 3.75) in the univariate analysis and MS length <2 mm (OR 2.25, 95% CI 1.06 to 4.82) in the multivariate analysis. On the multivariate analysis including procedural variables, predilatation (OR 2.41, 95% CI 1.01 to 5.83), self-expanding valves (Corevalve, Evolut R, and Evolut Pro/Pro+; Medtronic Inc., Minneapolis, Minnesota) or mechanical expanding valves (Lotus/Lotus Edge; Boston Scientifics, Marlborough, Massachusetts) (OR 3.00, 95% CI 1.31 to 6.91), and implantation depth > MS length (OR 4.27, 95% CI 1.81 to 10.08) were significantly associated with new PPI. The incidence of new PPI increased according to the number of baseline predictors (0: 20.9%, 1: 34.3%, and ≥2: 52.0%) and procedural predictors (0: 3.7%, 1: 20.9%, 2: 40.5%, and 3: 60.0%). New PPI risk in a preexisting RBBB subset could be stratified by baseline factors. Device selection and implantation strategy considering MS length could prevent new PPI even in these high-risk population., Competing Interests: Declaration of competing interest Dr. Moriyama reports financial support was provided by the Japanese Circulation Society. Dr. Ochiai reports a relation with Medtronic Inc that includes: speaking and lecture fees. Dr. Shishido reports a relation with Medtronic Inc that includes: speaking and lecture fees. Dr. Laine reports a relation with Teleflex Inc that includes: funding grants. Dr. Laine reports a relation with Boston Scientific Corp that includes: consulting or advisory. Dr. Laine reports a relation with Edwards Lifesciences Corporation that includes: consulting or advisory. Dr. Laine reports a relation with Medtronic Inc that includes: consulting or advisory. Dr. Moriyama reports a relation with Abbott that includes: speaking and lecture fees. Dr. Moriyama reports a relation with Edwards Lifesciences Corporation that includes: speaking and lecture fees. Dr. Moriyama reports a relation with Medtronic Inc that includes: speaking and lecture fees. Coauthors are clinical proctors of Edwards Lifesciences (SAPIEN) – Drs. Vähäsilta, Saito, and Moriyama. Co-author is a clinical proctor of Medtronic (CoreValve) – Dr. Saito. Co-author is a clinical proctor of Abbott (Navitor) – Dr. Saito Co-author is a clinical proctor of Boston Scientific (ACURATE neo) – Dr. Moriyama. The remaining authors have no competing interests to declare., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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38. Pre-Existing Left Bundle Branch Block and Clinical Outcomes After Transcatheter Aortic Valve Replacement.
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Saito T, Inohara T, Tsuruta H, Yashima F, Shimizu H, Fukuda K, Ohno Y, Nishina H, Izumo M, Asami M, Naganuma T, Mizutani K, Yamawaki M, Tada N, Yamanaka F, Shirai S, Noguchi M, Ueno H, Takagi K, Watanabe Y, Yamamoto M, and Hayashida K
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Background: Few reports on pre-existing left bundle branch block (LBBB) in patients undergoing transcatheter aortic valve replacement (TAVR) are currently available. Further, no present studies compare patients with new onset LBBB with those with pre-existing LBBB., Objectives: This study aimed to investigate the association between pre-existing or new onset LBBB and clinical outcomes after TAVR., Methods: Using data from the Japanese multicenter registry, 5,996 patients who underwent TAVR between October 2013 and December 2019 were included. Patients were classified into 3 groups: no LBBB, pre-existing LBBB, and new onset LBBB. The 2-year clinical outcomes were compared between 3 groups using Cox proportional hazards models and propensity score analysis to adjust the differences in baseline characteristics., Results: Of 5,996 patients who underwent TAVR, 280 (4.6%) had pre-existing LBBB, while 1,658 (27.6%) experienced new onset LBBB. Compared with the no LBBB group, multivariable Cox regression analysis showed that pre-existing LBBB was associated not only with a higher 2-year all-cause (adjusted HR: 1.39; 95% CI: 1.06-1.82; P = 0.015) and cardiovascular (adjusted HR: 1.60; 95% CI: 1.04-2.48; P = 0.031) mortality, but also with higher all-cause (adjusted HR: 1.43, 95% CI: 1.07-1.91; P = 0.016) and cardiovascular (adjusted HR: 1.81, 95% CI:1.12-2.93; P = 0.014) mortality than the new onset LBBB group. Heart failure was the most common cause of cardiovascular death, with more heart failure deaths in the pre-existing LBBB group., Conclusions: Pre-existing LBBB was independently associated with poor clinical outcomes, reflecting an increased risk of cardiovascular mortality after TAVR. Patients with pre-existing LBBB should be carefully monitored., Competing Interests: The OCEAN-TAVI registry is supported by Edwards Lifesciences, Medtronic, Boston Scientific, Abbott Medical, and Daiichi-Sankyo. Dr Izumo have served as a screening proctor for Edwards Lifesciences and a clinical proctor for Abbott Medical. Drs Shimizu and Takagi served as clinical proctors for Edwards Lifesciences. Drs Yashima, Ohno, and Asami served as clinical proctors for Medtronic. Drs Naganuma, Mizutani, Tada, Ueno, and Watanabe served as clinical proctors for Edwards Lifesciences and Medtronic. Drs Shirai, Yamamoto, and Hayashida served as clinical proctors for Edwards Lifesciences, Abbott Medical, and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)
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- 2024
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39. Clinical Implication of Supra-Normal Left Ventricular Ejection Fraction in Patients Undergoing Transcatheter Aortic Valve Replacement.
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Imamura T, Hida Y, Ueno H, Kinugawa K, Yashima F, Tada N, Yamawaki M, Shirai S, Naganuma T, Yamanaka F, Noguchi M, Mizutani K, Takagi K, Watanabe Y, Yamamoto M, Asami M, Izumo M, Ohno Y, Nishida H, Hayashida K, and On Behalf Of The Ocean-Tavi Investigators
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Background: Individuals with heart failure displaying supra-normal left ventricular ejection fraction (snLVEF) may exhibit less favorable clinical outcomes in contrast to their counterparts with normal left ventricular ejection fraction (nLVEF). The distinctive characteristics and mid-term prognosis of individuals with severe aortic stenosis and snLVEF following transcatheter aortic valve replacement (TAVR) remain enigmatic., Methods: Among 7393 patients diagnosed with severe aortic stenosis who underwent TAVR between 2013 and 2019 and were enlisted in the optimized transcatheter valvular intervention (OCEAN-TAVI) multicenter registry (UMIN000020423), we selected patients with left ventricular ejection fraction (LVEF) ≥ 50%. snLVEF was defined as LVEF exceeding 65%. We compared the baseline characteristics and assessed three-year post-TAVR mortality and heart failure readmission rates between the snLVEF (LVEF > 65%) and nLVEF cohorts (LVER 50-65%)., Results: Our study cohort comprised 5989 patients (mean age 84.4 ± 5.1 years and 1783 males). Among these, 2819 patients were categorized within the snLVEF cohort, while the remaining 3170 were allocated to the nLVEF group. Individuals within the snLVEF cohort were more likely to be female and displayed lower levels of natriuretic peptides, as well as smaller left ventricular dimensions in comparison to their nLVEF counterparts ( p < 0.05 for all). The presence of snLVEF emerged as an independent predictor of the three-year composite endpoint relative to nLVEF, with an adjusted hazard ratio of 1.16 (95% confidence interval 1.02-1.31, p = 0.023) after accounting for several potential confounding factors., Conclusions: snLVEF was relatively common among candidates for TAVR with preserved ejection fraction. Patients harboring snLVEF appear to manifest a distinctive clinical profile and encounter less favorable clinical outcomes following TAVR in contrast to those characterized by nLVEF.
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- 2023
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40. Hemodynamics and Conduction Disturbance After Transcatheter Aortic Valve Implantation With SAPIEN3 Ultra Versus SAPIEN3: The HomoSAPIEN 2 Study.
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Moriyama N, Sugiyama Y, Miyashita H, Yokoyama H, Yamaguchi M, Ochiai T, Shishido K, Jalanko M, Yamanaka F, Vähäsilta T, Laine M, and Saito S
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- Humans, Aortic Valve surgery, Hemodynamics, Treatment Outcome, Aortic Valve Insufficiency surgery, Transcatheter Aortic Valve Replacement adverse effects
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The optimal percent oversizing (%OS) using the SAPIEN3 Ultra (S3U) weighing the incidence of paravalvular regurgitation (PVR) ≥ mild against the risk of conduction disturbance (CD) is not known. This study sought to define an optimal extent of the annulus area %OS suitable for transcatheter aortic valve implantation with the S3U compared with the SAPIEN3 (S3). A total of 350 patients with the S3U were compared with 606 patients with the S3. Patients were categorized depending on the degree of %OS. PVR ≥ mild was observed in 8.9% of patients with the S3U and in 21.8% of those with the S3 (p <0.001). The S3U demonstrated a sustainably lower incidence of PVR ≥ mild than the S3 in any extent of %OS. There was an inverse proportional relation between the extent of %OS and frequency of PVR ≥ mild in the S3, whereas the S3U group provided little change. The incidences of PVR ≥ mild were steady >5%OS in the S3 (5% to 10%OS: 13.3%, and >10%OS: 12.1%) and >0%OS in the S3U (0% to 5%OS: 5.9%, 5% to 10%OS: 6.0%, and >10%OS: 6.1%). An increasing %OS was independently associated with the occurrence of CD (<0%OS: 9.8%, 0% to 5%OS: 13.1%, 5% to 10%OS: 16.6%, and >10%OS: 19.2%, p = 0.012). The incidence of PVR ≥ mild and/or CD was the lowest (10.1%) in the 0% to 5%OS in patients with the S3U. In conclusion, the HomoSAPIEN2 study suggests that the S3U tolerates a lesser degree of %OS for mitigating PVR ≥ mild than the S3. Minimal %OS, ranging from 0% to 5%, may be optimal for the S3U with balancing the risk of PVR and CD. Trial Identifier: UMIN000040413/URL: https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000046115., Competing Interests: Declaration of Competing Interest Dr. Moriyama has received honoraria for lectures from Abbott, Edwards Lifesciences, and Medtronic, is a clinical proctor of Edwards Lifesciences (SAPIEN) and Boston Scientific (ACURATE neo), and received a research grant from the Japanese Circulation Society. Dr. Ochiai has received honoraria for lectures from Medtronic. Dr. Shishido has received honoraria for lectures from Medtronic. Dr. Vähäsilta is a clinical proctor of Edwards Lifesciences (SAPIEN). Dr. Laine reports receiving nonregulatory research grants from Teleflex and consultant fees from Boston Scientific, Edwards Lifesciences, and Medtronic. Dr. Saito is a clinical proctor of Edwards Lifesciences (SAPIEN), Medtronic (CoreValve), and Abbott (Navitor). The remaining authors have no competing interests to declare., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2023
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41. Rationale and design of Non-antithrombotic Therapy After Transcatheter Aortic Valve Implantation (NAPT) Trial.
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Inohara T, Otsuka T, Watanabe Y, Shirai S, Tada N, Yamanaka F, Ueno H, Ohno Y, Tabata M, Suzuyama H, Asami M, Yamawaki M, Izumo M, Yamasaki K, Nishina H, Fuku Y, Mizutani K, Yashima F, Yamamoto M, and Hayashida K
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- Humans, Platelet Aggregation Inhibitors adverse effects, Prospective Studies, Aspirin therapeutic use, Treatment Outcome, Transcatheter Aortic Valve Replacement adverse effects, Aortic Valve Stenosis surgery, Aortic Valve Stenosis drug therapy, Aortic Valve Stenosis etiology
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Background: Despite the wide implementation of transcatheter aortic valve implantation (TAVI), the optimal antithrombotic therapy after TAVI has not been established yet. Owing to the accumulating evidence supporting the efficacy and safety of single antiplatelet therapy (SAPT) over dual antiplatelet therapy, the latest guideline recommends life-long SAPT. However, there is scarce evidence supporting SAPT compared with non-antithrombotic therapy. Given the vulnerability of patients undergoing TAVI in terms of high bleeding risk, the benefit of SAPT may be canceled out by its potential increased bleeding risk., Study Design and Objectives: Non-antithrombotic Therapy After Transcatheter Aortic Valve Implantation (NAPT) Trial is a prospective, randomized controlled, open-label blinded endpoint multicenter trial conducted in Japan, testing the non-inferiority of non-antithrombotic therapy compared with aspirin monotherapy in patients who underwent TAVI and had no indications for long-term oral anticoagulation therapy (OAC). Patients who successfully underwent trans-femoral TAVI for severe aortic stenosis with either balloon-expandable or self-expandable valves are eligible for inclusion. Key exclusion criteria are (i) occurrence of perioperative complications (ii) indications of taking antithrombotic drugs for other reasons; (iii) eGFR <30 ml/min/1.73 m2 or hemodialysis or peritoneal dialysis. A total of 360 patients will be randomized (1:1) to aspirin monotherapy vs. non-antithrombotic therapy. The primary outcome is a composite of all-cause mortality, myocardial infarction, stroke, and bleeding. All bleeding events based on the Valve Academic Research Consortium 3 are included as a component of the primary outcome., Conclusion: The NAPT trial will determine the non-inferiority of a non-antithrombotic therapy compared with aspirin monotherapy after TAVI., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Drs. Shirai, Yamamoto, and Hayashida are clinical proctors for Edwards Lifesciences, Medtronics, and Abbott Medicals. Drs. Tada, Naganuma, Mizutani, Tabata, Ueno, and Watanabe are clinical proctors for Edwards Lifesciences and Medtronic. Dr. Izumo is a screening proctor for Edwards Lifesciences. Dr. Yashima is a clinical proctor for Medtronic. All other authors have no relationships relevant to the contents of this article to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2023
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42. Prognostic Value of Electrocardiographic Left Ventricular Hypertrophy After Transcatheter Aortic Valve Implantation: Insights from the OCEAN-TAVI Registry.
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Koga M, Izumo M, Yoneyama K, Akashi YJ, Yashima F, Tada N, Yamawaki M, Shirai S, Naganuma T, Yamanaka F, Ueno H, Tabata M, Mizutani K, Takagi K, Watanabe Y, Yamamoto M, and Hayashida K
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- Male, Humans, Aged, 80 and over, Female, Prognosis, Hypertrophy, Left Ventricular diagnosis, Hypertrophy, Left Ventricular epidemiology, Hypertrophy, Left Ventricular etiology, Registries, Aortic Valve surgery, Treatment Outcome, Transcatheter Aortic Valve Replacement adverse effects, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis surgery, Aortic Valve Stenosis complications
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Electrocardiogram (ECG) left ventricular hypertrophy (LVH) is associated with the prognosis of patients with aortic stenosis. However, the impact of the presence or absence of ECG-LVH on the clinical outcomes after transcatheter aortic valve implantation (TAVI) is limited. This study aimed to assess the prognostic value of ECG-LVH among patients with aortic stenosis treated by TAVI. A total of 1,667 patients who underwent TAVI were prospectively enrolled into the OCEAN-TAVI (Optimized CathEter vAlvular iNtervention-Transcatheter Aortic Valve Implantation) registry. A total of 1,446 patients (mean age 84 years; 29.9% men) were analyzed. The Sokolow-Lyon index was used to determine the presence of ECG-LVH. LVH was also assessed using transthoracic echocardiography (TTE). We investigated the association between ECG-LVH and all-cause and cardiovascular mortality. This study identified ECG-LVH and TTE-LVH in 743 (51.5%) and 1,242 patients (86.0%), respectively. The Kaplan-Meier analysis revealed that all-cause mortality was significantly higher among patients without ECG-LVH than among those with ECG-LVH (log-rank p <0.001). In the multivariable analysis, the absence of ECG-LVH was independently associated with all-cause mortality (hazard ratio 1.98, 95% confidence interval 1.39 to 2.82, p <0.001), regardless of the presence or absence of TTE-LVH. Furthermore, the presence of TTE-LVH with the absence of ECG-LVH was observed in 575 patients (40%), which was associated with cardiovascular mortality (hazard ratio 2.84, 95% confidence interval 1.56 to 5.17, p <0.001). In conclusion, the absence of ECG-LVH was independently associated with an increased risk of all-cause mortality after TAVI. Risk stratification using both ECG-LVH and TTE-LVH is a useful predictor of adverse clinical outcomes after TAVI., Competing Interests: Declaration of Competing Interest The OCEAN-TAVI registry is supported by the following companies: Edwards Lifesciences, Abbott, Medtronic, Boston Scientific, and Daiichi-Sankyo. Drs. Tada, Naganuma, Shirai, Mizutani, Ueno, Tabata, Watanabe, Yamamoto, and Hayashida are clinical proctors for Edwards Lifesciences and Medtronic. Dr. Takagi is a clinical proctor at Edwards Lifesciences. Dr. Izumo is a screening proctor at Edwards Lifesciences. The remaining authors have no competing interests to declare., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2023
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43. Diagnostic Performance of Noninvasive Computed Tomography-Derived Fractional Flow Reserve in Patients With Severe Aortic Stenosis.
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Yamanaka F, Shishido K, Moriyama N, Ochiai T, Sato D, Koyama E, Sugiyama Y, Tamaki Y, Yamada T, Hayashi T, Miyashita H, Yokoyama H, Kosaki R, Yamashita T, Yamaguchi M, Yamagishi T, Matsumoto T, Tobita K, Mizuno S, Tanaka Y, Murakami M, Takahashi S, Tsujita K, and Saito S
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- Humans, Predictive Value of Tests, Tomography, X-Ray Computed, Coronary Angiography, Computed Tomography Angiography, Severity of Illness Index, Fractional Flow Reserve, Myocardial, Coronary Stenosis diagnostic imaging, Coronary Stenosis therapy, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Coronary Artery Disease
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- 2023
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44. Single retinal image for diabetic retinopathy screening: performance of a handheld device with embedded artificial intelligence.
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Penha FM, Priotto BM, Hennig F, Przysiezny B, Wiethorn BA, Orsi J, Nagel IBF, Wiggers B, Stuchi JA, Lencione D, de Souza Prado PV, Yamanaka F, Lojudice F, and Malerbi FK
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Background: Diabetic retinopathy (DR) is a leading cause of blindness. Our objective was to evaluate the performance of an artificial intelligence (AI) system integrated into a handheld smartphone-based retinal camera for DR screening using a single retinal image per eye., Methods: Images were obtained from individuals with diabetes during a mass screening program for DR in Blumenau, Southern Brazil, conducted by trained operators. Automatic analysis was conducted using an AI system (EyerMaps™, Phelcom Technologies LLC, Boston, USA) with one macula-centered, 45-degree field of view retinal image per eye. The results were compared to the assessment by a retinal specialist, considered as the ground truth, using two images per eye. Patients with ungradable images were excluded from the analysis., Results: A total of 686 individuals (average age 59.2 ± 13.3 years, 56.7% women, diabetes duration 12.1 ± 9.4 years) were included in the analysis. The rates of insulin use, daily glycemic monitoring, and systemic hypertension treatment were 68.4%, 70.2%, and 70.2%, respectively. Although 97.3% of patients were aware of the risk of blindness associated with diabetes, more than half of them underwent their first retinal examination during the event. The majority (82.5%) relied exclusively on the public health system. Approximately 43.4% of individuals were either illiterate or had not completed elementary school. DR classification based on the ground truth was as follows: absent or nonproliferative mild DR 86.9%, more than mild (mtm) DR 13.1%. The AI system achieved sensitivity, specificity, positive predictive value, and negative predictive value percentages (95% CI) for mtmDR as follows: 93.6% (87.8-97.2), 71.7% (67.8-75.4), 42.7% (39.3-46.2), and 98.0% (96.2-98.9), respectively. The area under the ROC curve was 86.4%., Conclusion: The portable retinal camera combined with AI demonstrated high sensitivity for DR screening using only one image per eye, offering a simpler protocol compared to the traditional approach of two images per eye. Simplifying the DR screening process could enhance adherence rates and overall program coverage., (© 2023. The Author(s).)
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- 2023
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45. Association between cancer history and second-generation drug-eluting stent thrombosis: insights from the REAL-ST registry.
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Hamana T, Otake H, Kuramitsu S, Shinozaki T, Ohya M, Horie K, Kawamoto H, Yamanaka F, Natsuaki M, Shiomi H, Nakazawa G, Ando K, Kadota K, Saito S, and Kimura T
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Background: Cancer-associated thrombosis is a frequent complication of cancer; however, little evidence is available regarding the association between cancer history and coronary artery stent thrombosis (ST). We aimed to investigate the relationship between cancer history and second-generation drug-eluting stent thrombosis (G2-ST)., Methods: From the REAL-ST (Retrospective Multicenter Registry of ST After First- and Second-Generation Drug-Eluting Stent Implantation) registry, this study evaluated 1265 patients (G2- ST cases, n = 253; controls, n = 1012) with cancer-related information available., Results: The prevalence of patients with cancer history was higher (12.3% vs. 8.5%, p = 0.065), and that of currently diagnosed and currently treated cancer was significantly higher in ST cases than controls (3.6% vs. 1.4%, p = 0.021; 3.2% vs. 1.3%, p = 0.037, respectively). Multivariable logistic regression analysis revealed that cancer history was associated with late ST (odds ratio [OR]: 2.80, 95% confidence intervals [CI]: 0.92-8.55, p = 0.071) and very late ST (OR: 2.40, 95% CI: 1.02-5.65, p = 0.046), but not with early ST (OR: 1.01, 95% CI: 0.51-2.00, p = 0.97). During the median follow-up period of 872 days after the index ST events, patients with cancer history showed a higher mortality than those without, among both ST cases (hazard ratio [HR]: 1.93, 95% CI: 1.06-3.51, p = 0.031) and controls (HR: 1.93, 95% CI: 1.09-3.40, p = 0.023)., Conclusion: A post hoc analysis of REAL-ST registry revealed that patients with G2-ST had a higher prevalence of currently diagnosed and currently treated cancer. Notably, cancer history was associated with the occurrence of late and very late ST, but not with early ST., (© 2023. The Author(s).)
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- 2023
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46. Impact of High Implantation of Transcatheter Aortic Valve on Subsequent Conduction Disturbances and Coronary Access.
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Ochiai T, Yamanaka F, Shishido K, Moriyama N, Komatsu I, Yokoyama H, Miyashita H, Sato D, Sugiyama Y, Hayashi T, Yamashita T, Tobita K, Matsumoto T, Mizuno S, Tanaka Y, Murakami M, Takahashi S, Makkar R, and Saito S
- Subjects
- Humans, Treatment Outcome, Tomography, X-Ray Computed, Aortic Valve diagnostic imaging, Aortic Valve surgery, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Background: Data regarding the impact of high transcatheter heart valve (THV) implantation on coronary access after transcatheter aortic valve replacement (TAVR) as assessed by postimplantation computed tomography (CT) are scarce., Objectives: The authors sought to assess the impact of high THV implantation on coronary access after TAVR., Methods: We included 160 and 258 patients treated with Evolut R/PRO/PRO+ and SAPIEN 3 THVs, respectively. In the Evolut R/PRO/PRO+ group, the target implantation depth was 1 to 3 mm using the cusp overlap view with commissural alignment technique for the high implantation technique (HIT), whereas it was 3 to 5 mm using 3-cusp coplanar view for the conventional implantation technique (CIT). In the SAPIEN 3 group, the HIT employed the radiolucent line-guided implantation, whereas the central balloon marker-guided implantation was used for the CIT. Post-TAVR CT was performed to analyze coronary accessibility., Results: HIT reduced the incidence of new conduction disturbances after TAVR for both THVs. In the Evolut R/PRO/PRO+ group, post-TAVR CT showed that the HIT group had a higher incidence of the interference of THV skirt (22.0% vs 9.1%; P = 0.03) and a lower incidence of the interference of THV commissural posts (26.0% vs 42.7%; P = 0.04) with access to 1 or both coronary ostia compared with the CIT group. These incidences were similar between the HIT and CIT groups in the SAPIEN 3 group (THV skirt: 0.9% vs 0.7%; P = 1.00; THV commissural tabs: 15.7% vs 15.3%; P = 0.93). In both THVs, CT-identified risk of sinus sequestration in TAVR-in-TAVR was significantly higher in the HIT group compared with the CIT group (Evolut R/PRO/PRO+ group: 64.0% vs 41.8%; P = 0.009; SAPIEN 3 group: 17.6% vs 5.3%; P = 0.002)., Conclusions: High THV implantation substantially reduced conduction disturbances after TAVR. However, post-TAVR CT revealed that there is a risk for unfavorable future coronary access after TAVR and sinus sequestration in TAVR-in-TAVR. (Impact of High Implantation of Transcatheter Heart Valve during Transcatheter Aortic Valve Replacement on Future Coronary Access; UMIN000048336)., Competing Interests: Funding Support and Author Disclosures Dr Ochiai has received honoraria for lectures from Edwards Lifesciences and Medtronic. Dr Moriyama has received honoraria for lectures from Edwards Lifesciences and Medtronic; and has been a clinical proctor for Edwards Lifesciences and Boston Scientific. Dr Makkar has received grant support from Edwards Lifesciences; has served as a consultant for Abbott Vascular, Cordis, and Medtronic; and owns equity in Entourage Medical. Dr Saito is a clinical proctor for Edwards Lifesciences and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
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- 2023
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47. Impact of Mild Paravalvular Regurgitation on Long-Term Clinical Outcomes After Transcatheter Aortic Valve Implantation.
- Author
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Yokoyama H, Sugiyama Y, Miyashita H, Jalanko M, Ochiai T, Shishido K, Yamanaka F, Vähäsilta T, Saito S, Laine M, and Moriyama N
- Subjects
- Humans, Female, Aged, Aged, 80 and over, Male, Retrospective Studies, Treatment Outcome, Aortic Valve surgery, Risk Factors, Transcatheter Aortic Valve Replacement methods, Aortic Valve Stenosis complications, Aortic Valve Insufficiency epidemiology, Aortic Valve Insufficiency surgery, Aortic Valve Insufficiency etiology, Heart Valve Prosthesis adverse effects, Heart Valve Prosthesis Implantation methods
- Abstract
The impact of mild paravalvular regurgitation (PVR) after transcatheter aortic valve implantation (TAVI) remains controversial. We evaluated the impact of mild PVR after TAVI on long-term clinical outcomes. We included patients who underwent TAVI for severe symptomatic aortic stenosis between December 2008 and June 2019 at 2 international centers and compared all-cause death between the group with mild PVR (group 1) and the group with none or trace PVR (group 2). PVR was categorized using a 3-class grading scheme, and patients with PVR ≧ moderate and those who were lost to follow-up were excluded. This retrospective analysis included 1,404 patients (mean age 81.7 ± 6.5 years, 58.0% women). Three hundred fifty eight patients (25.5%) were classified into group 1 and 1,046 patients (74.5%) into group 2. At baseline, group 1 was older and had a lower body mass index, worse co-morbidities, and more severe aortic stenosis. To account for these differences, propensity score matching was performed, resulting in 332 matched pairs. Within these matched groups, during a mean follow-up of 3.2 years, group 1 had a significantly lower survival rate at 5 years (group 1: 62.0% vs group 2: 68.0%, log-rank p = 0.029, hazard ratio: 1.41 [95% confidence interval: 1.04 to 1.91]). In the matched cohort, patients with mild PVR had a significant 1.4-fold increased risk of mortality at 5 years after TAVI compared with those with none or trace PVR. Further studies with more patients are needed to evaluate the impact of longer-term outcomes., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2023
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48. Current state of knowledge and information sharing among home healthcare professionals involved in heart failure management.
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Shimomoto R, Kubo T, Yamanaka F, Tsuchihashi-Makaya M, Suganuma N, and Kitaoka H
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- Humans, Cross-Sectional Studies, Surveys and Questionnaires, Information Dissemination, Delivery of Health Care, Heart Failure therapy
- Abstract
Background: The current state of knowledge related to disease management of heart failure (HF) and information coordination practices provided by non-physician healthcare professionals such as nurses and therapists working at home-visit nursing stations in Japan are not well known., Methods: A questionnaire survey of healthcare professionals working at home-visit nursing stations was conducted in Kochi Prefecture. Data collected from 151 nurses and therapists were analyzed., Results: Regarding the basic characteristics of the respondents, the majority were in their 30s and 40s, and approximately 75 % were nurses. In terms of HF knowledge, 53.7 % of respondents said that they "knew" about the New York Heart Association classification. A total of 40.0 % of respondents said that they were "aware of the existence of the HF handbook", and only 29.3 % of respondents said that they "knew" the classification of HF stages. When they were asked about their level of satisfaction related to all medical information provided by the hospital and hospital wards, no one was "very satisfied", and the most common response (66.2 %) was "not very satisfied". In the essential medical information that respondents wanted to obtain from hospitals and hospitals wards for managing HF patients at home, "medication at discharge", "current medical history", "fluid intake and restrictions", "symptoms, signs, and response to exacerbation", and "ideal body weight" were the top five contents., Conclusion: In the cross-sectional study targeted healthcare professionals working at home-visit nursing stations in Kochi Prefecture, the current state of knowledge related to HF and information coordination practices among healthcare professionals were not fully satisfactory in HF management. It is necessary to increase educational opportunities regarding HF for them and further promote information sharing., Competing Interests: Declaration of competing interest The authors have no conflict of interest with a company, organization, or institution to be disclosed., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2023
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49. Early Effect of Transcatheter Mitral Valve Repair on Cardiac Sympathetic Nerve Activity.
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Yokoyama H, Shishido K, Mizuno S, Yamanaka F, and Saito S
- Abstract
Background: Cardiac sympathetic nerve activity (SNA) is overactivated in heart failure patients and associated with clinical outcomes. The aim of this study is to investigate the early effect of MitraClip repair on cardiac SNA., Methods: We evaluated the change of cardiac SNA by
123 I- meta-iodobenzylguanidine (MIBG) scintigraphy in patients who underwent MitraClip repair from March 2019 to June 2020 in our hospital. Patients without acute procedural success were excluded, including patients who died or underwent mitral valve surgery before discharge. MIBG scintigraphy was performed at baseline and 1 month after MitraClip repair., Results: We analyzed 48 patients (mean age 78.6 ± 10 years; 52.1% male; 37 secondary mitral regurgitation [SMR]/11 primary mitral regurgitation [PMR]). MR severity and New York Heart Association functional class significantly improved from baseline to 1 month after MitraClip repair (both p < 0.001). Overall, delay heart-mediastinum ratio (H/M) had no significant change, and washout rate (WR) showed a decreasing trend (delay H/M; pre 2.07 ± 0.46, post 2.05 ± 0.49, paired p = 0.348, WR; pre 36.1 ± 11.6%, post 33.6 ± 11.7%, paired p = 0.061). In PMR patients, WR was significantly decreased, however, delay H/M was not (delay H/M; pre 2.15 ± 0.50, post 2.10 ± 0.57, paired p = 0.019, WR; pre 34.6 ± 10.5%, post 26.7 ± 13.8%, paired p = 0.568). In contrast, in SMR patients, neither delay H/M nor WR were significantly changed (delay H/M; pre 2.05 ± 0.45, post 2.03 ± 0.47, paired p = 0.474, WR; pre 36.6 ± 11.9%, post 35.7 ± 10.4%, paired p = 0.523)., Conclusions: Our study demonstrates that MitraClip repair could significantly decrease cardiac SNA of WR in PMR patients during 1-month follow-up, however, in SMR patients, the significant change of MIBG parameters was not observed., Competing Interests: The authors report no conflict of interest., (© 2023 The Author(s).)- Published
- 2023
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50. Discordance between fractional flow reserve and instantaneous wave-free ratio in patients with severe aortic stenosis: A retrospective cohort study.
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Yamanaka F, Shishido K, Yokota S, Moriyama N, Ochiai T, Yamada T, Hayashi T, Miyashita H, Yokoyama H, Yamanaga K, Tabata N, Yamaguchi M, Yamagishi T, Matsumoto T, Tobita K, Mizuno S, Tanaka Y, Murakami M, Takahashi S, Saito S, and Tsujita K
- Subjects
- Humans, Coronary Angiography, Retrospective Studies, Cardiac Catheterization, Predictive Value of Tests, Coronary Vessels, Severity of Illness Index, Fractional Flow Reserve, Myocardial, Coronary Stenosis diagnosis, Aortic Valve Stenosis diagnosis
- Abstract
Background: Discordance between fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) occurs in approximately 20 % of cases. However, no studies have reported the discordance in patients with severe aortic stenosis (AS). We aimed to evaluate the diagnostic discordance between FFR and iFR in patients with severe AS., Methods: We examined 140 consecutive patients with severe AS (164 intermediate coronary artery stenosis vessels). FFR and iFR were calculated in four quadrants based on threshold FFR and iFR values of ≤0.8 and ≤0.89, respectively (Group 1: iFR >0.89, FFR >0.80; Group 2: iFR ≤0.89, FFR >0.80; Group 3: iFR >0.89, FFR ≤0.80; and Group 4: iFR ≤0.89, FFR ≤0.80). Concordant groups were Groups 1 and 4, and discordant groups were Groups 2 and 3. Positive and negative discordant groups were Groups 3 and 2, respectively., Results: The median (Q1, Q3) FFR and iFR were 0.84 (0.76, 0.88) and 0.85 (0.76, 0.91), respectively. Discordance was observed in 48 vessels (29.3 %). In the discordant group, negative discordance (Group 2: iFR ≤0.89 and FFR >0.80) was predominant (45 cases, 93.6 %). Multivariate analysis showed that the left anterior descending artery [odds ratio (OR), 3.88; 95 % confidence interval (CI): 1.54-9.79, p = 0.004] and peak velocity ≥5.0 m/s (OR, 3.21; 95%CI: 1.36-7.57, p = 0.008) were independently associated with negative discordance (FFR >0.8 and iFR ≤0.89)., Conclusions: In patients with severe AS, discordance between FFR and iFR was predominantly negative and observed in 29.3 % of vessels. The left anterior descending artery and peak velocity ≥5.0 m/s were independently associated with negative discordance., Competing Interests: Declaration of competing interest The author(s) declare(s) that there is no conflict of interest., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2023
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