Publications by authors named "Matsuo Hitoshi"
Background: Limited large-scale, real-world data exist on the prevalence and clinical impact of discordance between fractional flow reserve (FFR) and nonhyperemic pressure ratios (NHPRs).
Methods: The J-PRIDE registry (Clinical Outcomes of Japanese Patients With Coronary Artery Disease Assessed by Resting Indices and Fractional Flow Reserve: A Prospective Multicenter Registry) prospectively enrolled 4304 lesions in 3200 patients from 20 Japanese centers. The lesions were classified into FFR+/NHPR-, FFR-/NHPR+, FFR+/NHPR+, or FFR-/NHPR groups according to cutoff values of 0.
Background: Computed tomography (CT) assessment is the standard for predicting coronary obstruction (CO) caused by sinus sequestration (SS) during transcatheter aortic valve (TAV) implantation in degenerated TAV (TAV-in-TAV) procedure, but it may not always be accurate. This report describes a prediction method for CO by using balloon aortic valvuloplasty (BAV) during TAV-in-TAV.
Case Summary: An 87-year-old woman with a history of balloon-expandable transcatheter heart valve (BE-THV) implantation 7 years prior was admitted with worsening dyspnoea.
Background: The angiography-derived non-hyperemic pressure ratio (angioNHPR) is a novel index of NHPR based on artificial intelligence (AI) that does not require pressure wires. We investigated the diagnostic accuracy of angioNHPR for detecting hemodynamically relevant coronary artery disease.
Methods And Results: In this retrospective single-center study, angioNHPR was assessed using the invasive NHPR as the reference standard.
Background: The fat attenuation index (FAI) measured using coronary computed tomography angiography (CCTA) enables the direct evaluation of pericoronary adipose tissue composition and vascular inflammation. We aimed to investigate the association of fractional flow reserve (FFR) and plaque vulnerability with coronary inflammation.
Methods: Patients with suspected coronary artery disease (CAD) who underwent CCTA and invasive FFR measurements within 90-day were included.
Article Synopsis
- The study aimed to develop a real-time measurement of fractional flow reserve (FFR) using intravascular ultrasound (IVUS), which improves upon traditional offline methods that take about 10 minutes.
- It involved analyzing coronary lesions with at least 25% stenosis, taking measurements of IVUS and FFR before and after stent placement.
- Results showed a strong correlation (r=0.896) between the newly developed IQ-FFR and traditional wire-derived FFR, indicating high accuracy (87.5%) in predicting post-stent FFR levels, making IQ-FFR a promising tool for assessing coronary lesions.
Background: Because the clinical benefit of antiplatelet therapy (APT) for patients with nonsignificant coronary artery disease (CAD) remains poorly understood, we evaluated it in patients after fractional flow reserve (FFR)-guided deferral of revascularization.
Methods And Results: From the J-CONFIRM (Long-Term Outcomes of Japanese Patients with Deferral of Coronary Intervention Based on Fractional Flow Reserve in Multicenter Registry), we investigated 265 patients with deferred lesions who did not require APT for secondary prevention of cardiovascular disease. A 2-year landmark analysis assessed the relationship between APT at 2 years and 5-year major cardiac adverse events (MACE: composite of all-cause death, target vessel-related myocardial infarction, clinically driven target vessel revascularization).
Background: J waves may be augmented by coronary angiography (CAG) or intracoronary drug administration but the underlying mechanism is unknown.
Purpose: The effect of intracoronary normal saline (NS) on J waves were investigated.
Patients And Methods: After the standard CAG using iopamidol (Iopamiro Inj), NS was injected into the right coronary artery in 10 patients with and eight patients without J waves at the baseline.
Article Synopsis
- The hyperaemic stenosis resistance (HSR) index is a new measure that combines pressure drop and blood flow to provide a better assessment of coronary artery disease severity compared to traditional methods like fractional flow reserve (FFR) and coronary flow reserve (CFR).
- This study analyzed data from 853 patients with chronic coronary syndromes to evaluate HSR's diagnostic and prognostic value, finding it to more accurately identify inducible ischaemia and predict long-term target vessel failure.
- The results suggest HSR can help determine which obstructed vessels may benefit from treatment, reinforcing its potential as a superior tool in clinical practice for managing coronary artery disease.
Article Synopsis
- A study was conducted to improve the prediction of which coronary artery lesions could lead to acute coronary syndrome (ACS) by integrating artificial intelligence (AI) with traditional methods.
- The research focused on patients who had undergone coronary CT angiography (CTA) before experiencing an ACS event, analyzing both culprit (problematic) and nonculprit lesions.
- The new model incorporating AI features showed significantly better predictability for identifying high-risk lesions compared to standard methods, suggesting that AI can enhance cardiac risk assessment.
Article Synopsis
- Study investigated how well the pullback pressure gradient (PPG) can predict successful outcomes in percutaneous coronary intervention (PCI) for patients with diffuse coronary artery disease.
- PPG was found to have a strong correlation with changes in fractional flow reserve (FFR) post-PCI, significantly better than using FFR alone for predicting optimal revascularization.
- The research highlights that PPG can influence treatment decisions and improve safety during PCI procedures, particularly for patients at risk of complications.
Article Synopsis
- There is limited data on the outcomes of patients with diabetes who undergo IVUS-guided PCI, particularly in cases of multivessel disease.
- The study enrolled 1,021 patients, comparing those with diabetes (560 patients) to those without (461 patients), focusing on the incidence of serious health events after the procedure.
- Results showed similar one-year clinical outcomes for both groups, indicating that diabetes did not significantly increase risks after the procedure when managed with modern practices.
Background: Vessel-level physiological data derived from pressure wire measurements are one of the important determinant factors in the optimal revascularisation strategy for patients with multivessel disease (MVD). However, these may result in complications and a prolonged procedure time.
Aims: The feasibility of using the quantitative flow ratio (QFR), an angiography-derived fractional flow reserve (FFR), in Heart Team discussions to determine the optimal revascularisation strategy for patients with MVD was investigated.
Aims: Coronary computed tomography angiography provides non-invasive assessment of coronary stenosis severity and flow impairment. Automated artificial intelligence (AI) analysis may assist in precise quantification and characterization of coronary atherosclerosis, enabling patient-specific risk determination and management strategies. This multicentre international study compared an automated deep learning-based method for segmenting coronary atherosclerosis in coronary computed tomography angiography (CCTA) against the reference standard of intravascular ultrasound (IVUS).
View Article and Find Full Text PDFDespite guideline-based recommendation of the interchangeable use of instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) to guide revascularization decision-making, iFR/FFR could demonstrate different physiological or clinical outcomes in some specific patient or lesion subsets. Therefore, we sought to investigate the impact of difference between iFR and FFR-guided revascularization decision-making on clinical outcomes in patients with left main disease (LMD). In this international multicenter registry of LMD with physiological interrogation, we identified 275 patients in whom physiological assessment was performed with both iFR/FFR.
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- The study investigated how smoking status affects the coronary volume-to-myocardial mass ratio (V/M) in individuals with coronary artery disease (CAD) who underwent CT analysis.
- It included a sample of 2,874 participants, revealing that former smokers had higher coronary volume than never-smokers, while current smokers had greater myocardial mass but both groups exhibited lower V/M ratios compared to never-smokers.
- The findings suggest that both current and former smoking status are significant predictors of lower V/M, alongside other factors like diabetes and severity of coronary stenosis.
Article Synopsis
- - The study examines the relationship between luminal stenosis, computed tomography-derived fractional-flow reserve (FFR), and high-risk plaque features on coronary CT angiography, focusing on their impact on patient outcomes and plaque volume measurements.
- - Data from 4,430 patients were analyzed using artificial intelligence to assess coronary plaque and determine optimal plaque volume cutoffs, considering factors like age, sex, hypertension, and diabetes.
- - Results showed that patients with total plaque volume and percent atheroma volume above specific cutoffs faced higher risks of major adverse cardiac events and late revascularization within one year.
Alcohol septal ablation (ASA) is performed for symptomatic drug-refractory hypertrophic obstructive cardiomyopathy to reduce the left ventricular outflow tract pressure gradient (LVOTPG) by injecting ethanol into a septal branch that perforates the septal bulge. The target septal branches usually arise directly from the left anterior descending (LAD) artery; however, vessels from a non-LAD artery can be selected in some cases. This study aimed to compare the effectiveness and safety between ASA performed using a septal branch arising from a non-LAD artery and a branch arising from the LAD artery.
View Article and Find Full Text PDFInvasive functional coronary angiography (FCA), an angiography-derived physiological index of the functional significance of coronary obstruction, is a novel physiological assessment tool for coronary obstruction that does not require the utilization of a pressure wire. This technology enables operators to rapidly evaluate the functional relevance of coronary stenoses during and even after angiography while reducing the burden of cost and complication risks related to the pressure wire. FCA can be used for treatment decision-making for revascularization, strategy planning for percutaneous coronary intervention, and procedure optimization.
View Article and Find Full Text PDFThe relationship between sex differences and long-term outcomes after fractional flow reserve (FFR)- and instantaneous wave-free ratio (iFR)-guided deferral of revascularization has yet to be elucidated. From the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on FFR in a multicenter registry), this study included 432 lesions from 385 patients (men, 323 lesions in 286 patients; women, 109 lesions in 99 patients) with paired data of FFR and iFR. The primary endpoint was the cumulative 5-year incidence of target vessel failure (TVF), including cardiac death, target vessel-related myocardial infarction, and clinically driven target vessel revascularization.
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- The microvascular resistance reserve (MRR) is a new index used to evaluate how well the coronary circulation can dilate, particularly in patients with coronary artery disease (CAD), and its assessment may require special considerations for women.
- This study aimed to evaluate how effective the MRR is for diagnosis and prognosis in women compared to men, using data from the ILIAS Registry.
- Results showed that MRR is a significant predictor of major adverse cardiac events (MACE) for both sexes, with similar correlations and cut-off values for predicting outcomes in women and men.