Gender Differences in Cardiovascular Events among Patients with Sleep Apnoea Syndrome: A Real-World Data Analysis of a Nationwide Epidemiological Dataset.

Aim: Sleep apnoea syndrome (SAS) is a common sleep disorder associated with heightened cardiovascular risks, yet sex-specific differences in these risks remain unclear.

Methods: This retrospective observational cohort study utilized the JMDC Claims Database, covering >5 million individuals in Japan. We analyzed data from 4,173,702 individuals (2,406,930 men, 1,766,772 women) after excluding those with central SAS, cardiovascular disease, and incomplete lifestyle questionnaire data.

A mutually communicable external system resource in remote monitoring for cardiovascular implantable electronic devices.

Background: Using third-party resources to manage remote monitoring (RM) data from implantable cardiac electronic devices (CIEDs) can assist in device clinic workflows. However, each hospital-acquired data is not used for further analysis as big data.

Methods And Results: We developed a real-time and automatically centralized system of CIED information from multiple hospitals.

Quality Indicators in Patient Referral Documents for Heart Failure in Japan.

This study examined quality indicators (QIs) for heart failure (HF) in patients' referral documents (PRDs).We conducted a nationwide questionnaire survey to identify information that general practitioners (GPs) would like hospital cardiologists (HCs) to include in PRDs and that HCs actually include in PRDs. The percentage of GPs that desired each item included in PRDs was converted into a deviation score, and items with a deviation score of ≥ 50 were defined as QIs.

Consensus Report on Destination Therapy in Japan - From the DT Committee of the Council for Clinical Use of Ventricular Assist Device Related Academic Societies.

Destination therapy (DT) is the indication to implant a left ventricular assist device (LVAD) in a patient with stage D heart failure who is not a candidate for heart transplantation. The implantable LVAD has been utilized in Japan since 2011 under the indication of bridge to transplant (BTT). After almost 10 year lag, DT has finally been approved and reimbursed in May 2021 in Japan.

Differences in Priorities for Heart Failure Management Between Cardiologists and General Practitioners in Japan.

Background: The purpose of this study was to clarify the current status and issues of community collaboration in heart failure (HF) using a nationwide questionnaire survey.

Methods and results: We conducted a survey among hospital cardiologists and general practitioners (GPs) using a web-based questionnaire developed with the Delphi method, to assess the quality of community collaboration in HF. We received responses from 46 of the 47 prefectures in Japan, including from 281 hospital cardiologists and 145 GPs.

Appropriateness rating for the application of optimal medical therapy and multidisciplinary care among heart failure patients.

Aims: Clinical guidelines for improving the patients' quality of care vary in clinical practice, particularly in super-aging societies, like in Japan. We aimed to develop a set of appropriate-use criteria (AUC) for contemporary heart failure (HF) management to assist physicians in decision making.

Methods And Results: With the use of the RAND methodology, a multidisciplinary writing group developed patient-based clinical scenarios in 10 selected key topics, stratified mainly by HF stage, age, and renal function.

Inverse relationship of subjective daytime sleepiness to mortality in heart failure patients with sleep apnoea.

Aims: Patients with sleep apnoea (SA) and heart failure (HF) are less sleepy than SA patients without HF. HF and SA both increase sympathetic nervous system activity (SNA). SNA can augment alertness.

Uremic Toxins and Atrial Fibrillation: Mechanisms and Therapeutic Implications.

Atrial fibrillation (AF) is the most prevalent arrhythmia in the general population. There is a close association between chronic kidney disease (CKD) and AF. In recent years, attention has been focused on the relationship between AF and uremic toxins, including indoxyl sulfate (IS).

Relationship of stroke volume to different patterns of Cheyne-Stokes respiration in heart failure.

Study Objectives: In patients with heart failure (HF) and reduced left ventricular ejection fraction (HFrEF), stroke volume (SV) falls during hyperpnea of Cheyne-Stokes respiration with central sleep apnea (CSR-CSA). We have identified two distinct patterns of hyperpnea: positive, in which end-expiratory lung volume (EELV) remains at or above functional residual capacity (FRC), and negative, in which EELV falls below FRC. The increase in expiratory intrathoracic pressure generated by the latter should have effects on the heart analogous to external chest compression.

Possible associations between palliative care conferences and positive outcomes when performing palliative care for patients with end-stage heart failure: a nationwide cross-sectional questionnaire survey.

Palliative care for end-stage heart failure should be provided by a multidisciplinary team. However, the influence of each occupational category on patients receiving palliative care for end-stage heart failure remains unclear. Thus, this study investigated the relationships between palliative care conferences and positive outcomes of palliative care for end-stage heart failure patients.

Design of a nationwide survey on palliative care for end-stage heart failure in Japan.

Background: The term palliative care has historically been associated with support for individuals with advanced incurable cancer, so cardiologists and cardiac nurses may be unfamiliar with its principles and practice. However, palliative care is now a part of end-stage heart failure management. We conducted the first nationwide survey to investigate the status of palliative care for heart failure in Japan.

[Home Medical Care for Heart Failure].

As heart failure progresses to the end stage, it becomes more difficult to maintain the same level of quality of life using the established therapy for the heart failure patients. We believe that an innovative home medical care for heart failure therapy that focuses on the individual's quality of daily living and early intervention is necessary. The roles of home medical care include: early discharge to home as opposed to long hospitalization; the prevention of re-hospitalization; the provision of good care; treatment of any exacerbations; and options available at the end of the patient's life at home.

Long-Term Prognostic Role of the Diagnostic Criteria for Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia.

Objectives: The aim of this study was to evaluate the long-term prognostic role of the 2010 task force criteria (TFC)-based scoring in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D).

Background: Categories of the 2010 TFC include the risk factors for cardiovascular mortality and sudden cardiac death in patients with ARVC/D.

Methods: Ninety patients with ARVC/D who met the definitive diagnosis of the 2010 TFC were retrospectively studied.

Overnight Effects of Obstructive Sleep Apnea and Its Treatment on Stroke Volume in Patients With Heart Failure.

Background: We previously showed in heart failure (HF) patients that obstructive respiratory events during sleep and generation of negative intrathoracic pressure during Mueller manoeuvres, mimicking obstructive apneas, acutely reduced stroke volume (SV). We also showed that treating obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) increased left ventricular ejection fraction over a 1-month period. We therefore hypothesized that, in HF patients, those with OSA would have greater overnight declines in SV and cardiac output (CO) than in those without sleep apnea, and that therapy of OSA using CPAP would prevent these declines.

Impact of myocardial reperfusion status on QT dispersion after successful recanalization of the infarct-related artery in acute myocardial infarction.

Objective: To determine whether adequate myocardial perfusion status after transluminal recanalization is associated with prompt improvement of QT dispersion (QTd).

Background: Transluminal recanalization of the infarct-related coronary artery in acute myocardial infarction aims to promptly restore myocardial perfusion, to maximize electrical and mechanical recovery. QTd represents the heterogeneity of ventricular repolarization, which may affect electrical stability.

Effect of rostral fluid shift on pharyngeal resistance in men with and without obstructive sleep apnea.

Background: Obstructive sleep apnea (OSA) relates to overnight rostral fluid shift, possibly because fluid accumulation around the pharynx increases pharyngeal resistance (Rph). We hypothesised that Rph will increase more in men with than without OSA in response to rostral fluid redistribution.

Methods: Seventeen men with, and 12 without OSA were randomized to lower body positive pressure (LBPP) for 15min or control, then crossed over.

Association between sleep apnea and overnight hemodynamic changes in hospitalized heart failure patients with and without paroxysmal nocturnal dyspnea.

Background: Paroxysmal nocturnal dyspnea (PND) is a common symptom for patients with acute decompensated heart failure (ADHF). Some symptoms of PND are similar to those of sleep apnea (SA) which might be associated with overnight worsening hemodynamics in failing hearts. However, the association between PND, SA, and overnight change in hemodynamics in patients with heart failure remains uncertain.

Clinical features and outcome in hospitalized heart failure in Japan (from the ATTEND Registry).

Background: Hospitalized heart failure (HHF) is a critical issue in Japan. To improve its management and outcomes, the clinical features, in-hospital management, and outcomes should be analyzed to improve the guidelines for HHF.

Methods And Results: The acute decompensated heart failure syndromes (ATTEND) registry is the largest study of HHF in Japan.