Publications by authors named "Kazuki Wakaume"
Aims: In heart failure (HF), inflammation is linked to malnutrition and impaired physical function. In this study, we aimed to assess how novel nutritional-inflammatory markers and lymphocyte-to-C-reactive protein ratio (LCR) and score (LCS) are associated with the nutritional status, physical function, and prognosis of patients with HF.
Methods And Results: This study was a secondary analysis of the FRAGILE-HF study, a prospective observational study conducted across 15 hospitals in Japan.
Article Synopsis
- Frailty in elderly heart failure patients correlates with overall mortality, but specific causes of death remain underexplored, prompting further investigation into multidomain frailty's role.
- The study analyzed 1,181 hospitalized patients, finding that as frailty increased (measured across physical, social, and cognitive domains), so did the risk of death, particularly from noncardiovascular causes.
- Results indicated that patients with higher frailty scores (2 or 3 domains) had a significantly increased risk of noncardiovascular death, while the association was not as strong for heart failure or other cardiovascular deaths.
Background: Frailty is associated with a poor prognosis in older patients with heart failure (HF). However, multidomain frailty assessment tools have not been established in patients with HF, and the association between the frailty phenotype and the deficit-accumulation frailty index in these patients is unclear. We aimed to understand this relationship and evaluate the prognostic value of the deficit-accumulation frailty index in older patients with HF.
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- Researchers aimed to evaluate the Ishii score, which considers age, grip strength, and calf circumference, to predict sarcopenia and its potential impact on 1-year mortality in heart failure patients.
- In a study with 1262 participants, 936 were assessed for sarcopenia, finding that 184 had the condition, with the Ishii score demonstrating good predictive accuracy, especially for men (0.87) compared to women (0.73).
- The results indicated that a higher Ishii score was linked to increased 1-year mortality rates, making it a valuable tool for identifying at-risk older heart failure patients.
Article Synopsis
- The study investigated the overlap between cachexia and sarcopenia in older heart failure patients, finding that 32.7% had cachexia and 22.7% had sarcopenia, with 11% experiencing both conditions.* -
- Among the participants, those with both cachexia and sarcopenia had the highest death rates (17.5% over two years) and were identified as an independent risk factor for mortality.* -
- The findings indicate that while both conditions are common in older heart failure patients, the degree of overlap is less significant than expected, highlighting the need for patient awareness and targeted interventions.*
Article Synopsis
- The study investigates the predictive power of the six-minute walking test in patients with heart failure and preserved ejection fraction (HFpEF), focusing on its significance beyond traditional risk factors.
- It involved 513 older patients, with a follow-up period of two years, revealing that those who walked less than 166 meters had the highest mortality rate.
- The findings indicate that the six-minute walking distance is a valuable prognostic tool, improving the accuracy of survival predictions in HFpEF patients.
Article Synopsis
- The study aimed to explore how common sarcopenic obesity is among older heart failure patients, its link to physical fitness and frailty, and its impact on survival.
- Researchers analyzed data from 779 hospitalized older adults, finding that 19.3% had sarcopenia and 26.2% were classified as obese, with specific cutoff points for body fat.
- Results indicated that those with both sarcopenia and obesity had poorer physical performance and a significantly higher risk of death within a year, establishing sarcopenic obesity as a serious health concern in this group.
As frailty in older patients with acute heart failure (AHF) has an adverse effect on clinical outcomes, the addition of electrical muscle stimulation (EMS) to exercise-based early rehabilitation may improve the effects of treatment. Post hoc analysis was performed on a randomized controlled study for clinical outcomes and prespecified subgroups (ACTIVE-EMS: UMIN000019551). In this trial, 31 AHF patients aged ≥ 75 years with frailty (Short Physical Performance Battery [SPPB] score 4-9) were randomized 1:1 to receive treatment with an early rehabilitation program only ( = 16) or early rehabilitation with add-on EMS therapy ( = 15) for 2 weeks.
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- Frailty and sarcopenia are prevalent issues in elderly heart failure patients, with higher rates seen in women for frailty and in men for sarcopenia.
- Both conditions significantly impact the risk of 1-year mortality in heart failure patients, although frailty specifically predicted mortality only in men.
- The study found no significant gender interactions influencing the prognostic impact of frailty or sarcopenia, emphasizing that both conditions are detrimental for older patients regardless of sex.
Background: No reports explicitly examined the relationship between work defined as a certain type of social participation or role and the protective effect on the prognosis of patients with heart failure (HF) by preventing frailty. Therefore, this study examined whether social participation through work before admission relates to future adverse events in HF patients aged ≥65 years, and whether each frailty domain mediates the association between work and prognosis as a second analysis of a multi-centered prospective study (FRAGILE-HF study).
Methods: We retrospectively reviewed 1,332 older patients with HF whose work status before admission to the hospital were investigated.
Aims: There have been no investigations of the prevalence and clinical implications of coexistence of anaemia and frailty in older patients hospitalized with heart failure (HF) despite their association with adverse health outcomes. The present study was performed to determine the prevalence and prognostic value of the coexistence of anaemia and frailty in hospitalized older patients with HF.
Methods And Results: We performed post hoc analysis of consecutive hospitalized HF patients ≥65 years old enrolled in the FRAGILE-HF, which was the prospective, multicentre, observational study.
In elderly patients with acute heart failure (AHF), clinical outcome is adversely affected by frailty. Although a number of potentially effective interventions for frailty have been reported, little is known about the effects of rehabilitation programs in frail elderly AHF patients. We postulated that addition of electrical muscle stimulation (EMS), which induces muscle contraction without requiring patient volition, to early rehabilitation would be efficacious in frail elderly AHF patients.
View Article and Find Full Text PDFSoluble fms-like tyrosine kinase 1 (sFlt-1) is an endogenous inhibitor of vascular endothelial growth factor, which is involved in cardiovascular remodeling and atherosclerosis development. To examine the predictive role of sFlt-1 levels in patients with asymptomatic heart failure, we measured circulating sFlt-1 in patients with or without coronary artery disease (CAD). We analyzed 88 Japanese patients with CAD or patients at high risk for atherosclerosis and who were undergoing total risk management for cardiovascular disease prevention.
View Article and Find Full Text PDFBackground: Metabolic syndrome (MetS) is associated with an increased risk of the development of atherosclerotic cardiovascular disease (CVD). Interleukin-18 (IL-18), which is a pleiotropic proinflammatory cytokine with important regulatory functions in the innate immune response system, plays a crucial role in vascular pathologies. IL-18 is also a predictor of cardiovascular death in patients with CVD and is involved in atherosclerotic plaque destabilization.
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