Publications by authors named "Kuwata S"

Article Synopsis
  • A 10-year-old boy with long QT syndrome type 3 (LQT3) experienced severe episodes of torsade de pointes (TdP) associated with fast ventricular arrhythmias.
  • After replacing his implantable cardioverter-defibrillator, he faced an "electrical storm" that didn't improve even with rapid heart pacing.
  • Treatment with dexmedetomidine and verapamil successfully controlled the TdP, emphasizing the need to address specific rapid arrhythmias in patients with LQT3.
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Aims: Predictors of true degenerative mitral stenosis (MS) in patients with aortic stenosis who underwent transcatheter aortic valve implantation (TAVI) remain unknown. This study aimed to investigate the predictors and prognostic value of true degenerative MS in this population.

Methods And Results: We retrospectively reviewed the records of 760 consecutive patients who underwent TAVI.

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Article Synopsis
  • * A study involving 287 TAVR patients found that those with ESRD-HD are generally younger, more likely to be male, and have higher surgical risks, yet similar aortic valve complex characteristics to non-ESRD-HD patients.
  • * At the one-year mark, there were no significant differences in key health outcomes like death or stroke between ESRD-HD and non-ESRD-HD patients, indicating that TAVR is a viable option for
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Aims: Evidence for risk stratification using exercise stress echocardiography (ESE) in patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) is currently lacking. Cardiac power output (CPO) has demonstrated prognostic value in patients undergoing TAVI for severe AS. This study investigated prognoses in patients undergoing TAVI for severe AS and to explore the additional information that ESE can provide for risk stratification.

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Aims: Cardiac power output (CPO) measures cardiac performance, and its prognostic significance in heart failure with preserved ejection fraction (EF) has been previously reported. However, the effectiveness of CPO in risk stratification of patients with valvular heart disease and post-operative valvular disease has not been reported. We aimed to determine the association between CPO and clinical outcomes in patients with preserved left ventricular (LV) EF after transcatheter aortic valve implantation (TAVI).

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Article Synopsis
  • The study investigates the effectiveness of the extraaortic-valvular cardiac damage (EVCD) Stage in assessing risks for patients with moderate aortic stenosis (AS) and reduced left ventricular ejection fraction (LVEF).
  • Clinical data from 130 patients were analyzed, categorizing them into EVCD stages based on the level of cardiac damage, with follow-up highlighting significant outcomes like cardiac death and heart failure hospitalization.
  • Results showed that patients in EVCD Stage 3/4 had a higher risk of adverse events compared to those in Stage 1, suggesting the EVCD staging system can be a useful tool for risk stratification in this patient group.
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Sarcopenia is a common skeletal muscle disease in older people. Lower limb muscle strength is a good predictive value for sarcopenia; however, little is known about its genetic components. Here, we conducted a genome-wide association study (GWAS) for knee extension strength in a total of 3452 Japanese aged 60 years or older from two independent cohorts.

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Following the introduction in the latest European and American guidelines, transcatheter edge-to-edge repair has become a valid alternative to surgery for ineligible patients. Among the available technologies, MitraClip (Abbott) was the first to be introduced for the percutaneous treatment of mitral regurgitation with the edge-to-edge technique. Although its safety and effectiveness has been widely demonstrated, the optimal procedural results are highly dependent from operators' experience.

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Article Synopsis
  • * The case study highlights an eight-month-old girl with a significant ASD and BPD-PH, where her pulmonary pressures were higher than systemic pressures, leading to a complicated right-to-left shunt.
  • * After treating her with pulmonary preconditioning (dexamethasone and diuretics), the ASD was successfully closed, normalizing her heart pressures and improving oxygen saturation levels.
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Aims: Current evidence on the prognostic value of exercise stress echocardiography (ESE) in asymptomatic patients with low-gradient severe aortic stenosis (AS) is limited. Therefore, this study aimed to elucidate its prognostic implications for patients with low-gradient severe AS and determine the added value of ESE in risk stratification for this population.

Methods And Results: This retrospective observational study included 122 consecutive asymptomatic patients with either moderate [mean pressure gradient (MPG) < 40 mmHg and aortic valve area (AVA) 1.

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A 70-year-old patient with paroxysmal atrial fibrillation underwent left atrial appendage closure. The patient experienced transient hypotension during device implantation. The procedure was abandoned because of ST-T-wave changes on electrocardiography and elevated coronary flow velocity on transesophageal echocardiography, which indicated that the device caused coronary artery compression.

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A direct asymmetric reductive amination of α-keto acids catalyzed by Cp*Ir complexes bearing a chiral -(2-picolyl)sulfonamidato ligand is described. The combined use of optically active 2-phenyglycinol as an aminating agent is effective for the chemo- and stereoselective transfer hydrogenation using formic acid. The subsequent elimination of the hydroxyethyl moiety by orthoperiodic acid can afford various unprotected α-amino acids in satisfactory isolated yields (20 examples) with excellent optical purities (up to >99% ee).

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A high score for controlling nutritional status (CONUT) due to poor nutritional status has been associated with adverse outcomes in patients with chronic heart failure. However, because little is known about the effect of CONUT score on mortality rates after transcatheter mitral valve repair, we evaluated nutrition screening tools for prognosis prediction in patients undergoing transcatheter mitral valve repair using the MitraClip system. We retrospectively analyzed 148 patients with severe mitral regurgitation (MR) who underwent MitraClip implantation between April 2018 and April 2021.

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Background and objective The treatment for symptomatic meniscus-deficient knees with cartilage defects remains challenging on account of insufficient meniscal substitutes. One solution for this might involve combining meniscal allograft transplantation (MAT) and cartilage repair. In this study, we aimed to analyze the effectiveness and safety of MAT concomitant with cartilage repair for symptomatic lateral meniscus-deficient knees in a setting with limited availability of meniscal transplants in Japan.

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Background: The MitraClip G4 system is a new iteration of the transcatheter edge-to-edge repair system. We assessed the impact of the G4 system on routine practice and outcomes in secondary mitral regurgitation (2°MR).

Methods and results: Consecutive patients with 2°MR treated with either the MitraClip G2 (n=89) or G4 (n=63) system between 2018 and 2021 were included.

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Case: A 62-year-old woman with bilateral severe medial unicompartmental knee osteoarthritis underwent right high tibial osteotomy (HTO) at the age of 49 and left matrix-associated autologous chondrocyte implantation covering with periosteum (pMACI) with medial collateral ligament (MCL) release at age 52 years. At the 13-year follow-up, she could walk and trek with good clinical scores, had high patient satisfaction, and had cartilaginous reparative tissue seen at second-look arthroscopy in her left knee.

Conclusion: This case suggests that pMACI with MCL release might be a possible alternative to HTO in a varus knee undergoing cartilage replacement surgery when HTO is contraindicated.

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The safety and feasibility are still not well known for exercise-induced mitral regurgitation (MR). This study is aimed to assess and compare the hemodynamic and symptomatic changes in patients with significant secondary MR during exercise stress echocardiography (ESE) before and after transcatheter edge-to-edge repair (TEER). The study included a total of 15 patients with secondary MR who underwent ESE before and after TEER using the MitraClip system (Abbott, Abbott Park, IL, USA).

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Backgrounds: There are limited data on the clinical relevance of transvalvular flow rate (Q ) at rest (Q and at peak stress (Q ) during dobutamine stress echocardiography (DSE) in patients with low-gradient severe aortic stenosis (LG-SAS).

Methods: We retrospectively analyzed the clinical data of patients with LG-SAS who underwent DSE. LG-SAS was defined as an aortic valve (AV) area index of < .

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Aortic stenosis is a prevalent valvular heart disease, especially in the older people. They often coexist with other co-morbidities, and noncardiac surgery carries a higher risk because of the underlying valve condition. Despite the growing concern about the safety and optimal management of noncardiac surgery post-transcatheter aortic valve replacement (TAVR), there is limited evidence on this matter.

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Catechols possessing electron-withdrawing groups at the C3 position effectively underwent oxidative functionalization at the C4 position in the presence of phenyliodine(III) diacetate (PIDA) and heteroarene nucleophiles (e.g., indole, indazole, and benzotriazole) to produce the corresponding biaryl products.

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Background: Although right ventricular (RV) enlargement may affect RV diastolic dysfunction assessed by end-diastolic forward flow (EDFF) in patients with repaired tetralogy of Fallot (TOF), EDFF may also be modified by left ventricular (LV) hemodynamics. We hypothesized that EDFF is affected by LV hemodynamics, not limited to RV diastolic stiffening.

Methods and results: Among 145 consecutive patients with repaired TOF who underwent catheterization, hemodynamic properties in 47 with consistent EDFF and 75 without EDFF were analyzed.

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Very severe aortic stenosis (AS) has a poor prognosis even in asymptomatic patients, and asymptomatic very severe AS is a Class IIa indication for aortic valve replacement, although the safety and effectiveness of transcatheter aortic valve implantation (TAVI) for very severe AS is not well-established. This study included 366 patients undergoing TAVI at a single center, with 85 and 281 patients in the very severe AS (peak velocity ≥5 m/s or mean pressure gradient (PG) ≥60 mmHg) and severe AS groups, respectively. Procedural and clinical outcomes at 1-year follow-up were compared between groups.

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Background: Landmark trials showed that invasive pressure measurement (Fractional Flow Reserve, FFR) was a better guide to coronary stenting than visual assessment. However, present-day interventionists have benefited from extensive research and personal experience of mapping anatomy to hemodynamics.

Aims: To determine if visual assessment of the angiogram performs as well as invasive measurement of coronary physiology.

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