Publications by authors named "Nobutaka Kakuda"

Article Synopsis
  • The study examined how pre-transplant renal dysfunction affects post-heart transplant cardiac function and patient outcomes in those supported by a left ventricular assist device (LVAD).
  • The research included 132 patients who underwent heart transplantation, dividing them into groups based on kidney function (renal dysfunction vs. non-renal dysfunction).
  • Findings revealed that while cardiac function remained similar post-transplant, patients with renal dysfunction had higher mortality rates in the long term, highlighting the impact of kidney health on patient prognosis after heart transplant.
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Diastolic stiffness coefficient (β) and end-diastolic elastance (Eed) are ventricular-specific diastolic parameters. However, the diastolic function of right ventricle had not been investigated sufficiently due to the lack of established evaluation method. We evaluated the validity of these parameters calculated using only data of right heart catheterization (RHC) and assessed it in patients with restrictive cardiomyopathy (RCM) and cardiac amyloidosis.

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Background: Systemic sclerosis (SSc) is divided into diffuse and limited cutaneous SSc (dcSSc and lcSSc). The dcSSc subtype has more severe internal organ damage. This study aimed to assess whether cardiovascular magnetic resonance (CMR) parametric mapping could detect early cardiac involvement and evaluate differences between these two subtypes.

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Background: Driveline infection (DLI) following left ventricular assist device (LVAD) implantation remains an unresolved problem. Negative pressure wound therapy (NPWT) promotes wound healing by applying negative pressure on the surface of the wound. Recently, the prophylactic application of NPWT to closed surgical incisions has decreased surgical site infections in various postsurgical settings.

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Traumatic accidents sometimes cause primary traumatic tricuspid regurgitation (TR), and the diagnosis is occasionally delayed due to the load adaptability of the right ventricle, which may lead to fatal outcomes. Here, we report a case of a 28-year-old man with traumatic TR, which presented with late-onset exertional dyspnea 5 years after a blunt chest injury from a bicycle accident. The chordae tendineae of anterior tricuspid leaflet was ruptured with right heart dilatation, and he underwent surgical tricuspid valvuloplasty.

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Article Synopsis
  • The study compared hemodynamic outcomes and clinical events in heart transplant (HTx) patients based on their pulmonary vascular resistance (PVR) severity after left ventricular assist device (LVAD) implantation.
  • It analyzed 85 HTx recipients, finding significant differences in PVR and various pulmonary pressures between high (PVR > 3 WU) and low PVR groups, particularly notable at the 2-year mark post-transplant.
  • High residual PVR was associated with more frequent hospitalizations and increased intracardiac pressure, indicating its role as a critical predictor for adverse outcomes post-transplant.
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Background: There are some patients with advanced heart failure (HF), for whom implantable left ventricular assist device (LVAD) or heart transplantation (HTx) should be considered. Some of them need to be transferred between hospitals. There are few reports on the interhospital transfer of patients with advanced HF and their subsequent clinical course.

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Aims: Heart transplantation (HT) is an effective therapeutic option for end-stage heart failure. Infection is a major cause of morbidity and mortality after HT. Sarcopenia, defined as the loss of muscle mass and strength, is a common comorbidity in HT candidates with end-stage heart failure.

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Article Synopsis
  • Deep learning models can effectively analyze electrocardiograms (ECGs) to detect left ventricular (LV) dysfunction, enhancing diagnostic accuracy for cardiologists.
  • A study involved training a convolutional neural network on 23,801 ECGs, achieving a high accuracy of 94.5% in identifying LV dysfunction in a separate test set of 7,196 ECGs.
  • When cardiologists used the model's output, their accuracy increased from 78% to 88%, demonstrating significant improvement in identifying LV dysfunction with the model's assistance.
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Background: Implantable continuous-flow left ventricular assist device (LVAD) improve renal function in advanced heart failure. However, the long-term effects of LVAD on renal function have not been investigated thoroughly. We aimed to assess long-term renal function in patients with LVAD support and to identify predictors for late deterioration in renal function (LDRF).

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Article Synopsis
  • - The study developed a deep learning algorithm to identify subclinical cardiac sarcoidosis (CS) from echocardiographic movies, addressing challenges in early diagnosis.
  • - Researchers trained two 3D convolutional neural networks (3D-CNN) on a dataset of 302 echocardiographic movies, comparing a pretrained algorithm to a non-pretrained one; results showed the pretrained algorithm had a higher accuracy (AUC 0.842 vs. 0.724) similar to that of cardiologists.
  • - Findings suggest that using a 3D-CNN with transfer learning could be an effective method for detecting CS, particularly focusing on the mitral valve area in echocardiographic images.
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Background: Little evidence has been presented about the association between previous atopic/allergic disease and graft rejection after solid organ transplantation. Thus, we present a case wherein acute cellular rejection (ACR) after heart transplantation (HTx) was noted along with exacerbation of atopic disease.

Case Summary: A 32-year-old man was admitted at our hospital for regular monitoring of graft rejection.

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Few reports have discussed appropriate strategies for patient referrals to advanced heart failure (HF) centers with available left ventricular assist devices (LVADs). We examined the association between the characteristics and prognoses of referred patients with advanced HF and the bed volume of the referring hospitals. This retrospective analysis evaluated 186 patients with advanced HF referred to our center for consultation about the indication of LVAD between January 1, 2015, and August 31, 2018.

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The effects of empagliflozin, a sodium-glucose co-transporter 2 inhibitor, on neointimal response after drug-eluting-stent (DES) implantation remains unknown. Insufficiently controlled diabetes patients with coronary artery disease planned for DES stenting were consecutively enrolled. The patients were assigned to receive empagliflozin in addition to standard therapy or intensive therapy using other glucose-lowering drugs (oGLD).

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Hyperammonemic encephalopathy secondary to heart failure is rare and there had been little reports about effective treatment. Organ hypoperfusion or congestion by heart failure may lead to various organ dysfunctions, and liver and intestinal circulatory impairment might cause ammonia metabolic failure. Here, we report on the case of a patient with hyperammonemic encephalopathy that was secondary to heart failure, which was effectively treated by lactulose.

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In this paper, we look at the case of a 79 years old male who received a Wiktor stent (WS) implantation for myocardial infarction in proximal left anterior descending artery 18 years ago. Eleven years later, an Everolimus eluting stent (EES; Xience V™) was implanted for the proximal edge restenosis of WS from mid left main trunk to the middle part of WS. Seven years after EES implantation, the angiography and optical coherence tomography revealed in-stent restenosis with severe stent recoil just distal to the overlapping zone of WS.

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