Publications by authors named "Ayami Naito"

Background: Left atrial (LA) dysfunction is common in heart failure (HF) with preserved ejection fraction. However, data on the pathophysiologic impacts of impaired LA functional reserve remained limited. We sought to determine the association of abnormal LA dynamics during exercise with cardiovascular reserve, exercise capacity, and clinical outcomes.

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Aims: Cardiopulmonary exercise testing (CPET) combined with exercise echocardiography (CPETecho) allows simultaneous assessments of cardiac, pulmonary, and ventilation in heart failure (HF) with preserved ejection fraction (HFpEF). This study sought to determine whether simultaneous assessment of CPET variables could provide additive predictive value over exercise stress echocardiography in patients with dyspnoea.

Methods And Results: CPETecho was performed in 443 patients with suspected HFpEF (240 HFpEF and 203 controls without HF).

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Article Synopsis
  • The study focuses on heart failure with preserved ejection fraction (HFpEF), aiming to improve classification by incorporating exercise assessments alongside clinical characteristics.
  • A total of 265 HFpEF patients were tested through exercise stress echocardiography, leading to the identification of three distinct phenogroups based on various clinical and exercise-related parameters.
  • The phenogroups revealed differences in cardiac function, exercise capacity, and prognosis, with two groups showing higher rates of mortality and heart failure events compared to the third group.
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  • Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) benefit cardiovascular health, reducing adverse events in both diabetic and heart failure (HF) patients.
  • Recent guidelines endorse SGLT-2is for HF patients, but concerns about weight loss and adverse effects, particularly in those with frailty or sarcopenia, persist.
  • There's no clear consensus on the best methods to assess frailty or the appropriate criteria for safely prescribing SGLT-2is to HF patients, prompting a review of assessment techniques and treatment efficacy.
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Aims: Anemia is common in patients with heart failure with preserved ejection fraction (HFpEF) and is associated with exercise intolerance. However, there are limited data on how anemia contributes to reduced exercise capacity in patients with HFpEF. We aimed to characterize exercise capacity, cardiovascular and ventilatory reserve, and the oxygen (O) pathway in anemic patients with HFpEF.

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Aims: Heart failure with preserved ejection fraction (HFpEF) is a syndrome characterized by multiple cardiac reserve limitations during exercise. Cardiac power output (CPO) is an index of global cardiac performance and can be estimated non-invasively by echocardiography. We hypothesized that CPO reserve during exercise would be associated with impaired cardiovascular reserve, exercise intolerance, and adverse outcomes in HFpEF.

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Background: Exercise intolerance is the primary symptom of patients with heart failure with preserved ejection fraction (HFpEF). Chronotropic incompetence has been considered to be common and contribute to poor exercise capacity in HFpEF. However, clinical characteristics, pathophysiology, and outcomes of chronotropic incompetence in HFpEF remain poorly understood.

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Background: Hospitalization with a first episode of heart failure (HF) is a serious event associated with poor clinical outcomes in HF with preserved ejection fraction (HFpEF). Identification of HFpEF via detection of elevated left ventricular filling pressure at rest or during exercise may allow early intervention. Benefits of treatment with mineralocorticoid receptor antagonists (MRAs) in established HFpEF have been reported, but use of MRAs is not well studied in early HFpEF without prior HF hospitalization.

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Aims: Diagnosis of heart failure with preserved ejection fraction (HFpEF) remains challenging in patients presenting with chronic dyspnoea. We sought to determine the diagnostic value of reduced left atrial (LA) compliance during exercise to diagnose HFpEF.

Methods And Results: Ergometry exercise stress echocardiography was performed in 225 patients with HFpEF and 262 non-heart failure controls (non-cardiac dyspnoea [NCD]) in Protocol 1, where the diagnosis of HFpEF was defined by the HFA-PEFF algorithm.

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  • Venous thromboembolism (VTE), often called cancer-associated thrombosis (CAT), is a common issue among cancer patients, yet its clinical features are not well-studied.
  • A study analyzed 259 patients treated for pulmonary embolism (PE), finding that those with cancer were more often diagnosed incidentally and had lower severity of PE but experienced a worse prognosis.
  • Higher D-dimer levels at discharge were linked to poor outcomes, indicating that cancer patients might face a heightened risk of major cardiovascular events and mortality despite the less severe initial PE.
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Unlabelled: We report the case of a 79-year-old woman with essential thrombocythemia who presented with simultaneous two-vessel acute myocardial infarction (AMI) in the subacute phase of takotsubo cardiomyopathy. Despite sufficient anticoagulation therapy with warfarin to prevent thrombus formation in the left ventricle, the patient developed simultaneous two-vessel AMI in the right and left circumflex coronary arteries 16 days after the onset of takotsubo cardiomyopathy. Thromboembolism from the left ventricle associated with takotsubo cardiomyopathy was considered a potential cause of this event.

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