Publications by authors named "Koichiro Kinugawa"

Hypoxia-inducible factor-prolyl hydroxylase (HIF-PH) inhibitors have been developed as a treatment for renal anemia. However, their therapeutic impact on patients with concomitant heart failure remains uncertain. We investigated the impact of HIF-PH inhibitors on improving renal anemia and associated clinical outcomes in patients with heart failure.

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Even in current guideline-directed medical therapy, including recently introduced vasopressin type 2 receptor antagonist tolvaptan, congestion has not been resolved in patients with heart failure. Kampo medicine goreisan has been receiving considerable attention as an additional therapy for patients who are refractory to conventional diuretics therapy, including tolvaptan. However, the impact of goreisan on urine electrolytes remains uncertain.

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  • * Among 996 patients analyzed, those using the Impella 5.0/5.5 had significantly lower 30-day mortality rates compared to those using the smaller Impella 2.5/CP devices.
  • * The findings suggest that using the larger Impella 5.5 or upgrading from the smaller model could improve survival rates in patients with advanced AMI-CS on ECPELLA support.
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Patients with atrial fibrillation (AF) often present with concomitant significant mitral regurgitation (MR). Percutaneous left atrial appendage closure (LAAC) is indicated for patients with AF to prevent thromboembolism and reduce the need for long-term anticoagulation. Transcatheter edge-to-edge repair (TEER) is recommended for patients with significant MR.

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  • Interventions for heart conditions using transcatheter techniques can sometimes create an unintended atrial septal defect (IASD), leading to uncertain clinical outcomes.
  • An 84-year-old female with heart failure and mitral regurgitation underwent TEER treatment, which resulted in both mitral stenosis and an increasing IASD, negatively affecting her cardiac output.
  • Successfully closing the IASD improved her blood pressure and overall condition, suggesting that IASD closure may be beneficial for certain patients after such heart interventions, but careful assessment is necessary.
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A remote dielectric sensing (ReDS) system quickly quantifies pulmonary congestion. Nonetheless, its efficacy in predicting an in-hospital increase in plasma B-type natriuretic peptide levels, the potential surrogate of worsening heart failure, remains undetermined. Patients who underwent ReDS measurement on admission during their hospitalization in the general wards for heart failure between 2021 and 2022 were eligible.

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Background: Diet modification is a mainstay for the successful management of metabolic syndrome and potentially may reduce the risk of cardiovascular disease. Accurate estimation of essential nutrients in daily meals is currently challenging to quantify. HAKARIUM (AstraZeneca Co.

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  • Percutaneous left atrial appendage closure (LAAC) helps reduce stroke and bleeding events in patients with non-valvular atrial fibrillation, particularly those who cannot take anticoagulants, but patients with heart failure remain at risk.
  • In a study involving 937 patients, researchers evaluated the effect of baseline plasma B-type natriuretic peptide (BNP) levels on outcomes after LAAC, with 98% of the procedures being successfully completed.
  • Results showed that higher baseline plasma BNP levels were linked to an increased risk of stroke, bleeding events, and mortality, indicating the need for further research to optimize treatment strategies for these patients.
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Background: Our study investigated the prognostic impacts of the interval between collapse and the initiation of cardiopulmonary resuscitation (CPR), and subsequent intervals to defibrillation or epinephrine administration, on 30-day favorable neurological outcomes following out-of-hospital cardiac arrest (OHCA).

Methods And Results: This nationwide population-based cohort study used the All Japan Utstein Registry, encompassing OHCA patients in Japan between January 2006 and December 2021. The primary outcome was 30-day favorable neurological outcomes, defined as Cerebral Performance Category 1 or 2.

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Pemafibrate is a novel selective peroxisome proliferator-activated receptor-α modulator, which was demonstrated to reduce serum triglyceride levels with few drug-related adverse events in several clinical studies, as well as phase II and III clinical trials. One of the limitations of this medicine was the requirement of twice-daily oral administration, resulting in reduced medication adherence, particularly in elderly patients, who are rather good targets for this medicine. Recently, a once-daily extended-release (XR) tablet has been introduced.

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The optimal therapeutic approach to facilitate reverse remodeling is desired in patients with systolic heart failure following acute coronary syndrome (ACS). The association between heart rate (HR) and reverse remodeling in this cohort has remained elusive.Patients with left ventricular ejection fraction (LVEF) < 50% who received echocardiography assessments following ACS were retrospectively included.

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The clinical ramifications of adaptive servo-ventilation (ASV) therapy have stirred debate within the medical community. Given the potential detrimental effect of elevated expiratory positive airway pressure (EPAP) on cardiac output, we hypothesized that relatively lower EPAP may be recommended for successful ASV therapy. In-hospital patients with congestive heart failure refractory to medical therapy were included in the prospective cohort study of ASV therapy on prognosis in repeatedly hospitalized patients with chronic heart failure: longitudinal observational study of effects on readmission and mortality (SAVIOR-L) study.

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  • Heart failure is a common and serious complication following acute myocardial infarction, leading to high rates of mortality and increased healthcare costs.
  • The article discusses the established benefits of four key heart failure medications—β-blockers, mineralocorticoid receptor antagonists, angiotensin receptor-neprilysin inhibitors, and sodium-glucose cotransporter 2 inhibitors—mainly studied in patients with reduced ejection fraction.
  • It aims to provide an overview of current research on drug and device therapies that can help prevent heart failure in patients who have experienced an acute myocardial infarction.
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  • - The study investigates the relationship between spleen size and outcomes in heart failure patients receiving Impella temporary mechanical circulatory support from March 2018 to August 2023.
  • - Researchers calculated the splenic volume index (SVI) using CT scans at the time of Impella placement and analyzed its association with 30-day mortality rates.
  • - Results showed that a lower SVI and SVI/central venous pressure (CVP) ratio were linked to decreased cardiac output and increased short-term mortality, indicating that spleen size may be an important factor to consider in these patients.
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The utilization of temporary mechanical circulatory support (MCS) in the management of cardiogenic shock is experiencing a notable surge. Acute myocardial infarction remains the predominant etiology of cardiogenic shock, followed by heart failure. Recent findings from the DanGer Shock trial indicate that the percutaneous micro-axial flow pump support, in conjunction with standard care, significantly reduced 6-month mortality in patients with acute myocardial infarction-related cardiogenic shock compared to those receiving standard care alone.

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Impaired gastric motility in the form of constipation may often occur in elderly patients with chronic heart failure. Candidates for trans-catheter aortic replacement (TAVR) are of old age and have multiple comorbidities, probably including constipation. However, the clinical implication of a history of constipation in patients receiving TAVR remains unknown.

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Detailed heart rate (HR) response patterns during exercise in patients with heart failure (HF) and sinus rhythm remain uncertain. We screened consecutive patients with HF who underwent cardiopulmonary exercise tests at a large academic center from November 2013 to July 2023. HR response during exercise was statistically classified using logistic differential equation models.

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Vericiguat, a soluble guanylate cyclase stimulator known for augmenting cyclic guanosine monophosphate production, has garnered substantial clinical attention in patients with systolic heart failure. Despite its proven efficacy, discerning the specific subset of individuals who can enjoy clinical advantages from vericiguat therapy in contemporary real-world clinical practice, particularly among the individuals undergoing "quadruple medical therapy" comprising administration of a beta-blocker, angiotensin receptor neprilysin inhibitor, mineralocorticoid receptor antagonist, and sodium-glucose co-transporter 2 inhibitor, remains an unresolved query. This study involved patients undergoing 3-month vericiguat therapy alongside complete quadruple medical therapy in a contemporary real-world clinical practice.

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  • * A 74-year-old male with CTO in his right external iliac artery was successfully treated using the I-PAD method, which combines intravascular ultrasound (IVUS) and an angled guiding catheter.
  • * The procedure was completed quickly, without complications, suggesting that the I-PAD technique could improve the efficiency and safety of treating CTO lesions.
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