Publications by authors named "Nobuyuki Enzan"
Moderate/severe anemia [hemoglobin (Hb) < 10 g/dL] is recommended to be treated in patients with renal anemia. However, the optimal therapeutic target for Hb levels in patients with heart failure (HF) is unknown. This study aimed to investigate the impact of severity of anemia, especially moderate/severe anemia, associated with renal dysfunction (RD: eGFR < 60 mL/min/1.
View Article and Find Full Text PDFAims: Despite advances in therapies, the disease burden of heart failure (HF) has been rising globally. International comparisons of HF management and outcomes may reveal care patterns that improve outcomes. Accordingly, we examined clinical management and patient outcomes in older adults hospitalized for acute HF in the United States (US) and Japan.
View Article and Find Full Text PDFBackground: Although a tool for sharing patient prognosis among all medical staff is desirable in heart failure (HF) cases, only a few simple HF prognostic scores are available. We previously presented the AB score, a simple user-friendly HF risk score, and validated it in a small single-center cohort. In the present study, we validated it in a larger nationwide cohort.
View Article and Find Full Text PDFAims: Atrial fibrillation (AF) type (paroxysmal, persistent, or permanent) is important in determining therapeutic management; however, clinical outcomes by AF type are largely unknown for hospitalized patients with heart failure (HF).
Methods And Results: The Japanese Registry Of Acute Decompensated Heart Failure is a retrospective, multicenter, and nationwide registry of patients hospitalized for acute HF in Japan. Follow-up data were collected up to 5 years after hospitalization.
Article Synopsis
- Doxorubicin-induced cardiomyopathy is a serious condition with a poor prognosis, linked to inflammation of the heart muscle.
- Research shows that activating invariant natural killer T (iNKT) cells using α-galactosylceramide can reduce heart cell death and improve heart function affected by doxorubicin.
- The study highlights that the protective effects of iNKT cells are mediated through the IFN-γ-STAT1-ERK signaling pathway, which is crucial in countering the negative effects of doxorubicin.
Efficacy of Early Catheter Ablation for Atrial Fibrillation After Admission for Heart Failure.
JACC Clin Electrophysiol
September 2023
Article Synopsis
- - The study investigated how early catheter ablation (CA) for atrial fibrillation (AF) affects patients with heart failure (HF) who were hospitalized for worsening symptoms, comparing those who received early CA to a control group.
- - Results showed that patients who underwent early CA had significantly lower all-cause mortality rates and reduced cardiovascular and heart failure deaths in both the crude and matched cohorts.
- - The findings suggest that performing CA within 90 days of hospital admission can lead to better long-term health outcomes for patients suffering from both HF and AF.
Article Synopsis
- The study aimed to compare patients with heart failure and supra-normal ejection fraction (HFsnEF) to those with normal ejection fraction (HFnEF) to understand their characteristics and prognosis.
- Among 11,573 patients, 16.8% had HFsnEF, showing they were generally older, predominantly women, had lower natriuretic peptide levels, and smaller left ventricles than those with HFnEF.
- While the overall risk of cardiovascular death or heart failure readmission was similar for both groups, HFsnEF presented unique characteristics and prognosis, particularly in women and those with renal issues.
Background: The present study aimed to clarify the regional variations in clinical practice and the prognosis of patients with heart failure with reduced ejection fraction (HFrEF) in Japan using the Japanese Registry of Acute Decompensated Heart Failure (JROADHF).
Methods and results: We recruited data of hospitalized patients with HFrEF (n=4,329) from the JROADHF. The patients were divided into 6 groups based on the region of Japan where they were hospitalized: Hokkaido-Tohoku (n=504), Kanto (n=958), Chubu (n=779), Kinki (n=902), Chugoku-Shikoku (n=446), and Kyushu (n=740).
Background: The impact of early implementation of cardiac rehabilitation (CR) in heart failure (HF) patients remains to be elucidated. This study sought to determine whether CR during HF hospitalization could improve prognostic outcomes in patients with acute decompensated HF.
Methods: We analyzed patients with HF enrolled in the JROADHF (Japanese Registry of Acute Decompensated Heart Failure) registry, a retrospective, multicenter, nationwide registry of patients hospitalized for acute decompensated HF.
Background: Mitochondrial DNA (mtDNA)-induced myocardial inflammation is intimately involved in cardiac remodeling. ZBP1 (Z-DNA binding protein 1) is a pattern recognition receptor positively regulating inflammation in response to mtDNA in inflammatory cells, fibroblasts, and endothelial cells. However, the role of ZBP1 in myocardial inflammation and cardiac remodeling remains unclear.
View Article and Find Full Text PDFBackground: Dipeptidyl peptidase-4 (DPP-4) inhibitors have been shown to exert pleiotropic effects on heart failure (HF) in animal experiments.
Objectives: This study sought to investigate the impact of DPP-4 inhibitors on HF patients with diabetes mellitus (DM).
Methods: We analyzed hospitalized patients with HF and DM enrolled in the JROADHF (Japanese Registry Of Acute Decompensated Heart Failure) registry, a nationwide registry of acute decompensated HF.
Background: Little is known about nationwide temporal trends in the clinical characteristics and treatment of dilated cardiomyopathy (DCM) in Japan.
Methods and results: We collected data regarding demographics, echocardiography, and treatment of DCM between 2003 to 2013 from Clinical Personal Records, a national registry organized by the Japanese Ministry of Health, Labour, and Welfare. Among the 40,794 DCM patients screened, 27,702 with left ventricular ejection fraction (LVEF) <50% and age ≥18 years were enrolled in this study and divided into 3 groups according to registration year: Group 1, 2003-2005 (10,006 patients); Group 2, 2006-2010 (11,252 patients); and Group 3, 2011-2013 (6,444 patients).
Article Synopsis
- A higher resting heart rate (RHR) is linked to an increased risk of cardiovascular events in patients with type 2 diabetes mellitus (T2DM) and can be especially concerning for those with diabetic retinopathy.
- The study analyzed data from 4,746 T2DM patients without known cardiovascular disease, finding that those with RHRs of 70-79 bpm and ≥80 bpm faced a significantly higher risk of cardiovascular events compared to those with RHRs of 60-69 bpm.
- In conclusion, maintaining a lower RHR is crucial for T2DM patients with diabetic retinopathy, as RHRs of 70 bpm or higher are associated with increased cardiovascular event risks.
Article Synopsis
- - Ischemia-reperfusion (I/R) injury is a critical area for improving recovery after heart attacks, with ferroptosis—cell death caused by iron overload and lipid peroxides—playing a key role that is not fully understood.
- - Glutathione peroxidase 4 (GPx4) acts as an important protector against ferroptosis; its reduction increases susceptibility to I/R damage, highlighting the need for therapies targeting both ferroptosis and another type of cell death called mitochondrial permeability transition (MPT).
- - The study reveals that heme oxygenase 1 activation during hypoxia contributes to iron overload and ferroptosis, distinguishing it from MPT-driven damage, suggesting that combining drugs
Background: Previous studies have shown an association between hyperoxemia and mortality in patients with out-of-hospital cardiac arrest (OHCA) after cardiopulmonary resuscitation (CPR); however, evidence is lacking in the extracorporeal CPR (ECPR) setting.
Objective: The aim of this study was to test the hypothesis that hyperoxemia is associated with poor neurological outcomes in patients treated by ECPR.
Methods: The Japanese Association for Acute Medicine OHCA Registry is a multicenter, prospective, observational registry of patients from 2014 to 2017.
Background: In patients with type 2 diabetes mellitus (T2DM) without known cardiovascular disease, the association between B-type natriuretic peptide (BNP) and cardiovascular events except for heart failure has not been elucidated. We aimed to investigate this association in high-risk T2DM patients.
Methods: We analyzed the association between BNP and cardiovascular events, including coronary, cerebral, renal, and vascular events or cardiovascular death based on the single and serial measurement of BNP in T2DM patients with retinopathy and hyperlipidemia without known cardiovascular disease enrolled in the EMPATHY study.
Delayed administration of epinephrine is associated with worse neurological outcomes in patients with out-of-hospital cardiac arrest and initial pulseless electrical activity: insight from the nationwide multicentre observational JAAM-OHCA (Japan Association for Acute Medicine) registry.
Eur Heart J Acute Cardiovasc Care
June 2022
Aims: The delayed administration of epinephrine has been proven to worsen the neurological outcomes of patients with out-of-hospital cardiac arrest (OHCA) and shockable rhythm or asystole. We aimed to investigate whether the delayed administration of epinephrine might also worsen the neurological outcomes of patients with witnessed OHCA and initial pulseless electrical activity (PEA).
Methods And Results: The JAAM-OHCA Registry is a multicentre registry including OHCA patients between 2014 and 2017.
Aims: Angiotensin-converting enzyme inhibitors (ACEis) or angiotensin II receptor blockers (ARBs) have been shown to be associated with recovery of cardiac function in patients with dilated cardiomyopathy (DCM). The aim of this study was to assess comparative effectiveness of ACEis vs. ARBs on recovery of left ventricular ejection fraction (LVEF) among patients with DCM.
View Article and Find Full Text PDFMolecular mechanisms mediating cardiac hypertrophy by glucose metabolism are incompletely understood. Hexosamine biosynthesis pathway (HBP), an accessory pathway of glycolysis, is known to be involved in the attachment of O-linked N-acetylglucosamine motif (O-GlcNAcylation) to proteins, a post-translational modification. We here demonstrate that glutamine-fructose-6-phosphate amidotransferase 2 (GFAT2), a critical HBP enzyme, is a major isoform of GFAT in the heart and is increased in response to several hypertrophic stimuli, including isoproterenol (ISO).
View Article and Find Full Text PDFFemale sex is reported to be associated with poor prognosis in hypertrophic cardiomyopathy (HCM). The plasma B-type natriuretic peptide (BNP) concentration is a prognostic predictor in HCM. However, the effect of sex on BNP concentrations remains unclear among HCM patients.
View Article and Find Full Text PDFBackground: Beta-blockers have been shown to induce left ventricular reverse remodeling (LVRR) in heart failure with reduced ejection fraction. This study aimed to determine whether beta-blockers could induce LVRR in patients with heart failure with mid-range ejection fraction (HFmrEF).
Methods: We analyzed the national database from clinical personal records of dilated cardiomyopathy (DCM) maintained by Japanese Ministry of Health, Labour and Welfare, between 2003 and 2014.
Intensive lipid-lowering therapy is recommended in individuals exhibiting type 2 diabetes mellitus (T2DM) with microvascular complications (as high-risk patients), even without known cardiovascular disease (CVD). However, evidence is insufficient to stratify the patients who would benefit from intensive therapy among them. Hypertension is a major risk factor, and uncontrolled blood pressure (BP) is associated with increased CVD risk.
View Article and Find Full Text PDFArticle Synopsis
- The study focuses on improving heart failure (HF) patient management through individual risk stratification using machine learning (ML) algorithms on administrative claim data (ACD) to predict 1-year mortality.
- A total of 10,175 HF patients were analyzed, leading to the creation of a more accurate prediction model called SMART-HF, which incorporates top risk factors like age and renal disease identified through ML techniques.
- SMART-HF outperformed traditional models like the Seattle Heart Failure Model and MAGGIC based on c-statistic measurements, highlighting its potential as an easy-to-use tool for clinicians.
Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) have been shown to prevent left ventricular remodeling and improve outcomes of patients with heart failure (HF). This study aimed to investigate whether the use of ACEi/ARB could be associated with HF with recovered ejection fraction (HFrecEF) in patients with dilated cardiomyopathy (DCM).We collected individual patient data regarding demographics, echocardiogram, and treatment in DCM between 2003 and 2014 from the clinical personal record, a national database of the Japanese Ministry of Health, Labour and Welfare.
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