Publications by authors named "IWANAGA Y"

Background: Infective endocarditis (IE) is still a fatal disease, and given its rarity, ongoing updates to patient characteristics and outcomes of IE are essential for providing precision diagnoses and effective treatments. This study sought to examine temporal trends in the clinical characteristics and in-hospital occurrence of adverse outcomes of IE.

Methods And Results: Using the Japan nationwide administrative database, we identified patients with IE in Japan from 2016 to 2021.

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Unlabelled: Adipose-derived stem cells (ASCs) and their small extracellular vesicles (sEVs) hold significant potential for regenerative medicine due to their tissue repair capabilities. The microRNA (miRNA) content in sEVs varies depending on ASC status; however, the effects of aging and cell passage on miRNA profiles remain unclear. In this study, we examined the effects of donor age and cell expansion on ASC characteristics and transcriptome using ASCs obtained from three young and three old donors.

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Cardiovascular diseases (CVD) have imposed a substantial burden on population health and society. In Japan, the National Plan for the Promotion of Measures Against Cerebrovascular and Cardiovascular Disease, grounded in national legislation, seeks to improve the quality of care and standardize treatment for cerebrovascular disease and CVD. The plan emphasizes the need to develop standardized systems for collecting and disseminating medical information, as well as promoting data-driven research.

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Background: We aimed to examine the stepwise risk stratification for predicting major adverse cardiovascular events (MACE) in patients with DM and suspected coronary artery disease (CAD).

Method: 1187 patients with suspected CAD enrolled in a prospective cohort study were examined. The patients were evaluated step-by-step with coronary artery calcification (CAC), coronary artery stenosis (CAS), and FFR analysis.

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Evidence of the effectiveness of β-blockers in heart failure (HF) and atrial fibrillation (AF) in a contemporary cohort is controversial. This study investigated the association between the use of β-blockers and prognosis in hospitalized HF patients with and without AF in Japan. Patients hospitalized with the first episode of acute HF were identified from the National Database of Health Insurance Claims and Specific Health Checkups of Japan between April 2014 and March 2021.

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  • A study was conducted using data from over 522,000 ischemic stroke (IS) patients in Japan to explore the link between body mass index (BMI) and stroke-related disability.
  • The study found that 60.1% of patients experienced worsening disability during hospitalization, with overweight patients having the best odds of better outcomes at discharge.
  • The analysis revealed a U-shaped relationship between BMI and disability, suggesting that there's an optimal BMI of around 24.7 kg/m² for minimizing stroke-related disability.
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Background: Patients with heart failure exhibiting low systolic blood pressure (SBP) have a poor prognosis. Sacubitril/valsartan reduces cardiovascular events; however, its use in patients with low SBP has not been fully examined. Therefore, in this study, we aimed to investigate the association between baseline SBP and adverse events (AEs) in patients starting sacubitril/valsartan therapy using data from a real-world registry in Japan.

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  • The Japanese Catheter Ablation (J-AB) registry, launched in August 2017, is a nationwide voluntary study led by the Japanese Heart Rhythm Society focused on collecting data about catheter ablation procedures.
  • In January 2022, the registry's data collection system shifted from REDCap to the Fountayn system to improve data management.
  • By the end of 2022, the registry compiled data from 90,042 procedures across 614 hospitals, highlighting the types of arrhythmias, outcomes, and complications, with participants averaging 66.7 years old and 65.9% being male.
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  • Researchers developed new hydrophobic PEG hydrogels by using a method called gel-gel phase separation (GGPS) to enhance their applications as artificial extracellular matrices.
  • They found that increased elasticity of the gels improves hydrophobicity and cell adhesion, even though PEG gels are usually water-attracting.
  • The study demonstrated that these specially designed oligo-PEG gels showed better structural properties and cell attachment, paving the way for advancements in tissue engineering and regenerative medicine.
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  • - This study focused on the safety and effectiveness of catheter ablation for treating atrial fibrillation (AF) in elderly patients, analyzing data from 170,017 procedures over four years.
  • - Despite an increase in procedures for patients aged 80 and older, the overall complications rate was 2.8%, with higher risks as age increased, especially for those 85 and older.
  • - Recurrence rates of AF after ablation were consistent across different age groups, indicating that with proper patient selection, AF ablation is a viable treatment option for older adults.
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The hemodynamic impact of the implantation depth for balloon-expandable valves is under-investigated, especially with higher implantation techniques. We assessed the hemodynamic performance of supra-annular SAPIEN 3 valve implantation. This retrospective study involved consecutive patients who underwent transcatheter aortic valve replacement (TAVR) using the SAPIEN 3.

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Objectives The present study evaluated the usefulness of machine learning (ML) models with the coronary artery calcification score (CACS) and clinical parameters for predicting major adverse cardiac events (MACEs). Methods The Nationwide Gender-specific Atherosclerosis Determinants Estimation and Ischemic Cardiovascular Disease Prospective Cohort study (NADESICO) of 1,187 patients with suspected coronary artery disease (CAD) 50-74 years old was used to build a MACE prediction model. The ML random forest (RF) model was compared with a logistic regression analysis.

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We report the case of a 74-year-old woman with Parkinson's disease (PD) who developed acute dysphagia, dysarthria, and hoarseness. A neurological examination and nasopharyngeal fiberscopy revealed paralysis of the left glossopharyngeal, vagus, and hypoglossal nerves. No skin rash was observed.

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  • - The study aimed to compare the safety and effectiveness of transluminal foam sclerotherapy combined with endovenous laser ablation (EVLA) against EVLA alone for treating small saphenous vein incompetence, focusing on changes in the venous clinical severity score (VCSS) over one year.
  • - Researchers conducted the study by using a sheath for foam sclerotherapy during the EVLA procedure, assessing various outcomes such as VCSS changes, reflux recurrence, and complications at multiple time points after treatment.
  • - Results indicated that while the change in VCSS wasn't significantly impactful, the combination treatment (TLFS + EVLA) led to lower rates of residual or recurrent reflux compared to EVLA alone, suggesting TLFS
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  • * Results showed that AF patients had more severe initial strokes (higher NIHSS scores) and less favorable outcomes at discharge, although adjustments indicated some improvement for AF patients over time.
  • * Over the study period, AF patients experienced a noticeable decrease in stroke severity and an increase in favorable outcomes, suggesting that advances in stroke care benefits AF patients more than non-AF patients.
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Background: This registry aims to allow for a prospective non-interventional observational study of ulcerative colitis. This will facilitate monitoring of the current state of ulcerative colitis in Japan and improving the long-term disease course and adverse events associated with current treatment options.

Methods: Inclusion of patients from five centres in Japan is planned.

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Measurement of flow-mediated vasodilation (FMD) in the brachial artery by using ultrasound is a well-established technique for evaluating endothelial function. To make the measurement quicker and simpler than the measurements of conventional ultrasound FMD (uFMD), we have developed a new noninvasive method, plethysmographic FMD (pFMD), to assess vascular response to reactive hyperemia in the brachial artery. The aim of this study was to determine the accuracy of measurement of pFMD in comparison to that of measurement of conventional uFMD.

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  • The study introduced a new method called tip detection (TD) combined with a special wire (CP12ST) to enhance the effectiveness of treating chronic total occlusion (CTO) in coronary procedures.
  • Researchers compared the success rates and procedural times of the TD method with an existing technique (Stingray) using a different wire (CP20) in 54 total cases.
  • The findings showed that the TD method led to a significantly higher success rate (100% vs 67%) and shorter procedural times (145 minutes vs 185 minutes), with few complications in both groups.
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  • This study investigates myocardial dysfunction in patients with fulminant myocarditis using data from a nationwide registry in Japan, focusing on changes in cardiac function over time.
  • It included 214 patients, analyzing left ventricular ejection fraction (LVEF) at hospital admission, discharge, and one year post-discharge, noting significant improvements in LVEF.
  • Results indicate that patients with reduced LVEF (<50%) at discharge faced a much higher risk of death or heart transplantation compared to those with preserved LVEF (≥50%), highlighting the importance of cardiac function for prognosis.
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The utility of assessment of cardiovascular calcifications for predicting stroke incidence remains unclear. This study assessed the relationship between cardiovascular calcifications including coronary artery calcification (CAC), aortic valve (AVC), and aortic root (ARC) assessed by coronary computed tomography (CT) and stroke incidence in patients with suspected CAD. In this multicenter prospective cohort study, 1187 patients suspected of CAD who underwent coronary CT were enrolled.

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Background: Children's participation is an important outcome for children, families, and rehabilitation.

Objectives: We compared participation patterns (home and community) of 6- to 12-year-old Japanese children with autism and children with typical development (TD) and explored the associations of participation with familial, environmental, and child-related factors.

Method: Twenty-five mothers of children with autism and 21 mothers of TD children completed a survey covering their child's participation and environment, family empowerment, autism symptoms, sensory processing, behavior, and demographic characteristics.

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Background: The introduction of transcatheter edge-to-edge repair for moderate-to-severe or severe mitral regurgitation (MR) utilizing the MitraClip system became reimbursed and clinically accessible in Japan in April 2018. This study presents the 2-year clinical outcomes of all consecutively treated patients who underwent MitraClip implantation in Japan and were prospectively enrolled in the Japanese Circulation Society-oriented J-MITRA registry.

Methods and results: Analysis encompassed 2,739 consecutive patients enrolled in the J-MITRA registry with informed consent (mean age: 78.

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Challenging behavior (CB), the most common example being extreme self-injurious or aggressive/destructive behavior, is often observed as a major behavior issue in individuals with severe intellectual disabilities. This study investigated how CB changed among residents of a facility for people with disabilities before and after it was restructured from a traditional format single room shared by two to three individuals with approximately 20 residents lived together to a format featuring private areas with two rooms per resident and a unitcare system. Twenty-one residents of Care Home A, which was rebuilt in the new care format, were selected.

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Recent studies have showed that asymptomatic cerebral infarction (ACI) developed in a reasonable number of patients after cardiac catheterization. However, no study has investigated the long-term prognostic impact of ACI after cardiac catheterization. We investigated whether ACI after cardiac catheterization affects long-term mortality and subsequent cardiovascular events.

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