Publications by authors named "Eiichi Akiyama"
Association of Low Muscle Strength With Incident Pneumonia in Older Patients With Heart Failure.
J Gerontol A Biol Sci Med Sci
December 2024
Article Synopsis
- Older patients with heart failure (HF) experience a higher risk of developing pneumonia, which contributes to increased mortality rates.
- A study of 1,266 hospitalized patients aged 65 and older found that those with low muscle strength were significantly more likely to develop pneumonia post-discharge.
- Low muscle strength was identified as a strong predictor of pneumonia and associated with a fourfold increased risk of death after pneumonia onset.
Article Synopsis
- Tricuspid regurgitation (TR) is common in acute heart failure (AHF) and impacts patient prognosis, but the changes in TR severity during hospital stays are not well understood.
- A study of 1,079 AHF patients found that over half exhibited improvement in TR severity by discharge, with those maintaining severe TR facing worse outcomes like higher mortality and rehospitalization rates.
- Persistent TR severity after treatment is a significant indicator of poor prognosis, suggesting that ongoing TR may require further treatment in AHF patients upon hospitalization.
Article Synopsis
- Hypochloremia, defined as low chloride levels in the blood, is linked to higher mortality rates in heart failure (HF) patients and was studied to see if it enhances existing prognostic models.
- In a study of 2,496 hospitalized HF patients, those with hypochloremia had a significantly higher 1-year mortality rate (12.6% of patients had hypochloremia, with 15.5% deaths observed).
- Adding hypochloremia to established risk models improved predictive accuracy, suggesting it can provide valuable insights into patient outcomes post-discharge.
Article Synopsis
- High platelet-derived thrombogenicity in STEMI patients correlates with poor outcomes, and this study investigates the impact of acute inflammation on this condition.
- The research included 150 STEMI patients, measuring platelet-derived thrombogenicity and peak leukocyte counts to assess inflammatory responses.
- Findings indicate that patients with higher leukocyte counts exhibited significantly increased platelet-derived thrombogenicity and higher creatine kinase levels, highlighting leukocyte count as an independent factor influencing thrombogenicity during primary PCI.
Article Synopsis
- * Involving 410 patients, those with LDL-C levels less than 122 mg/dL faced a 2.3 times higher risk of serious health events (like death, heart attacks, and strokes) over a median follow-up of 6.1 years, compared to higher LDL-C patients.
- * Key factors linked to poor outcomes in the low LDL-C group were identified as frailty (slow gait speed), chronic inflammation (high C-reactive protein), and endothelial dysfunction.
Background: Pulmonary hypertension (PH) has recently been described as a complex clinical syndrome affecting multiple organ systems, including the heart, lungs, and skeletal muscle, each of which plays an important role in exercise capacity. However, the relationship between exercise capacity and skeletal muscle abnormalities in patients with PH has not been fully elucidated.
Methods: We retrospectively analysed the exercise capacity and measures of skeletal muscle of 107 patients with PH without left heart disease (mean age 63 ± 15 years, 32.
Patients with heart failure (HF) patients may die either suddenly (sudden cardiac death/SCD) or progressively from pump failure. The heightened risk of SCD in patients with HF may expedite important decisions about medications or devices. We used the Larissa Heart Failure Risk Score (LHFRS), a validated risk model for all-cause mortality and HF rehospitalization, to investigate the mode of death in 1363 patients enrolled in the Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure (REALITY-AHF).
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- The study aims to create a simple risk score, called 4 V-RS, for predicting in-hospital mortality in patients with acute heart failure (AHF) using a machine-learning method (LASSO regression).
- In both the derivation cohort (REALITY-AHF) and the validation cohort (NARA-HF), the model was found to have a higher predictive ability compared to the existing ADHERE risk model and performed similarly to the GWTG-BNP-Cl-RS model.
- The 4 V-RS consists of four key variables (systolic blood pressure, blood urea nitrogen, serum chloride, and C-reactive protein) and demonstrates that a simpler model can be just as effective in risk assessment
Article Synopsis
- Endothelial dysfunction increases the risk of major bleeding and adverse cardiovascular events in patients with acute coronary syndrome, as shown in a study of 674 patients over 6.1 years.
- 39.2% of patients were identified with endothelial dysfunction, which was linked to a greater likelihood of major bleeding (hazard ratio 2.29) and major cardiovascular events (hazard ratio 2.04).
- The study concluded that assessing endothelial dysfunction using the reactive hyperaemia index can help predict future cardiovascular issues and increased risk of cardiovascular death, while no association with non-cardiovascular death was found.
Background: Hypochloremia is a risk factor for poor outcomes in patients with acute heart failure (AHF). However, the changes in serum chloride levels during decongestion therapy and their impact on prognosis remain unknown.
Methods: In total, 2798 patients with AHF were retrospectively studied and divided into four groups according to their admission and discharge serum chloride levels: (1) normochloremia (n=2,192, 78%); (2) treatment-associated hypochloremia, defined as admission normochloremia with a subsequent decrease (<98 mEq/L) during hospitalization (n=335, 12%); (3) resolved hypochloremia, defined as admission hypochloremia that disappeared at discharge (n=128, 5%); (4) persistent hypochloremia, defined as chloride <98 mEq/L at admission and discharge (n = 143, 5%).
Aims: Reduced skeletal muscle mass is a major component of sarcopenia, associated with impaired exercise capacity and poor prognosis in patients with heart failure (HF). Measurement of skeletal muscle mass by dual-energy X-ray absorptiometry may be affected by fluid retention, typically in the patients' lower extremities. The aim of the present study was to elucidate the association between upper and lower extremity skeletal muscle mass (USM and LSM) and all-cause mortality in hospitalized patients with HF, after discharge.
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- The study examined how changes in the number of foundational medications for heart failure (FMHF) during hospital stays affect patient outcomes after discharge.
- Researchers analyzed data from three large registries in Japan, focusing on patients with heart failure and reduced left ventricular ejection fraction.
- Results showed that patients who had an increase in FMHF prescriptions at discharge had a significantly lower risk of rehospitalization and death within a year compared to those whose prescriptions stayed the same.
Early drop in systolic blood pressure is associated with poor diuretic response and prognosis in patients with acute heart failure.
Eur Heart J Acute Cardiovasc Care
November 2022
Aims: Although an excessive drop in systolic blood pressure (SBP) during acute heart failure (AHF) negatively impacts prognosis, the association between changes in SBP and the diuretic response (DR) is unclear. We aimed to clarify the association between an early drop in SBP and DR/prognosis in patients with AHF.
Methods And Results: This was a sub-analysis of the REALITY-AHF study, which registered patients with AHF admitted through emergency departments (EDs).
Article Synopsis
- * Out of 1,359 ICU patients, 372 received echocardiography, which was more common in those with cardiac issues, revealing lower heart function metrics compared to other patients.
- * Overall, early echocardiography did not significantly impact survival rates for all ICU patients, but it did improve one-year survival rates for those admitted specifically for cardiac conditions.
Although intravenous diuretics is a cornerstone of acute heart failure treatment (AHF), its optimal initial dose is unclear. This is a post-hoc analysis of the REALITY-AHF, a prospective multicentre observational registry of AHF. The initial intravenous diuretic dose used in each patient was categorised into below, standard, or above the recommended dose groups according to guideline-recommended initial intravenous diuretic dose.
View Article and Find Full Text PDFAims: Acute heart failure (AHF) is a clinical syndrome with a poor prognosis and a major public health concern worldwide. The aim of this study was to investigate whether carperitide administration improves the 1 year prognosis of patients with AHF and to check whether there is an optimal dose of the drug.
Methods And Results: We analysed the data of COOPERATE-HF-J (the Consortium for Pooled Data Analysis regarding Hospitalized Patients with Heart Failure in Japan), combining two cohorts (NARA-HF and REALITY-AHF), which included 2435 patients with acute decompensated heart failure.
Although hypochloremia is strongly associated with adverse prognosis in acute heart failure (AHF), it is unknown whether incorporating hypochloremia into the preexisting risk model improves the model performance. We calculated the Get With The Guidelines-Heart Failure (GWTG-HF) risk score in 1,428 patients with AHF (derivation cohort) and developed 2 risk scores incorporating brain natriuretic peptide (BNP) into the GWTG-HF risk score (GWTG-BNP risk score) and incorporating both BNP and hypochloremia (GWTG-BNP-Cl risk score). Hypochloremia was defined as <98 mmol/L.
View Article and Find Full Text PDFBackground And Aims: Both low appendicular skeletal muscle index (ASMI) and specific abdominal fat composition [i.e., increased visceral to subcutaneous (V/S) fat ratio] have been associated with cardiovascular events.
View Article and Find Full Text PDFBackground Recent data suggest that the angiotensin receptor neprilysin inhibitor modulates plasma levels of natriuretic peptides and attenuates the risk of hyperkalemia in patients with heart failure (HF). However, the impact of natriuretic peptides on serum electrolyte abnormalities, especially abnormalities in sodium and potassium levels in patients with HF remains unclear. Methods We performed a post-hoc analysis of a multicenter prospective cohort study in 162 patients with acute HF (74.
View Article and Find Full Text PDFThe significance of late diastolic velocity (a') obtained by tissue Doppler imaging (TDI), which reveals atrial function, in ST-elevation myocardial infarction (STEMI) remains unclear. This study evaluated the association of TDI parameters determined either immediately or 2 weeks after percutaneous coronary intervention (PCI) with long-term outcomes. In all, 740 patients with first-time STEMI underwent immediate PCI (i.
View Article and Find Full Text PDFBackground: Atrial fibrillation (AF) is a common arrhythmia in patients with acute heart failure (AHF). Heart rate (HR) also changes significantly over time. However, the association between changes in HR in AF patients and prognosis is uncertain.
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- - The study explores the significance of 3D speckle tracking echocardiography (STE) in predicting long-term outcomes for patients who experienced ST-elevation acute myocardial infarction (STEMI).
- - It involved 270 patients and measured cardiac function using both 2D and 3D STE, finding that 3D-STE indices were better indicators of major adverse cardiac events (MACEs) compared to 2D-STE.
- - The analysis identified 3D-global longitudinal strain (GLS) as the strongest predictor for MACEs, suggesting that high 3D-GLS and circumferential strain (GCS) values indicate a significantly increased risk for adverse heart outcomes over a
Prognostic impact of muscle and fat mass in patients with heart failure.
J Cachexia Sarcopenia Muscle
June 2021
Background: Cachexia, characterized by loss of muscle with or without loss of fat mass, is a poor prognostic factor in patients with heart failure (HF). However, there is limited investigation on the prognostic impact of muscle and fat mass separately in HF. We hypothesized that muscle and fat mass have different effects on the prognosis of HF.
View Article and Find Full Text PDFThis study aimed to evaluate the characteristics and prognosis of patients with vasospastic angina (VSA) diagnosed by a provocation test with a secondary prevention implantable cardioverter defibrillator (ICD), compared with patients with organic coronary stenosis. We retrospectively evaluated 309 consecutive patients who received an ICD implantation between January 2010 and March 2018 in our institutions. Of these patients, 206 were implanted with an ICD for secondary prevention.
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