Publications by authors named "Noriaki Tabata"
Background: Accurate prediction of prognosis in transthyretin amyloid cardiomyopathy (ATTR-CM) is crucial for optimal treatment selection, including tafamidis, the only approved therapy for ATTR-CM. Although tafamidis has been proven to improve prognosis, the long-term serial changes in comprehensive parameters related to ATTR-CM, including cardiac biomarkers and imaging parameters, under tafamidis remain unknown.
Methods And Results: In this study, we used Cox regression analysis on data from 258 consecutive patients diagnosed with ATTR-CM at Kumamoto University to determine prognostic factors.
CT-derived Extracellular Volume Fraction in Aortic Stenosis, Cardiac Amyloidosis and Dual Pathology.
Eur Heart J Cardiovasc Imaging
December 2024
Aims: To investigate CT-derived extracellular volume fraction (CT-ECV) in patients with lone aortic stenosis (AS), dual pathology of AS and transthyretin cardiac amyloidosis (AS-ATTR), and lone ATTR, and to examine the diagnostic performance and optimal cutoff values of CT-ECV for differentiating between patients with lone AS and AS-ATTR, and between patients with lone AS and lone ATTR.
Methods And Results: This retrospective study included consecutive patients with severe AS (including lone AS and AS-ATTR) and lone ATTR who underwent CT-ECV analysis and technetium 99m pyrophosphate (99mTc-PYP) scintigraphy. The diagnostic performance of CT-ECV for detecting cardiac amyloidosis was evaluated using the area under the receiver operating characteristic curve (AUC).
Background: Immunoglobulin light-chain (AL) amyloidosis is a lethal condition resulting from misfolded immunoglobulin ALs produced by clonal CD38-positive plasma cells. Treatment with daratumumab, an anti-human CD38 monoclonal antibody, led to higher frequencies of complete hematologic response and better clinical outcomes compared with conventional treatment. This study sought to evaluate the survival benefit of daratumumab-containing regimens in patients with AL cardiac amyloidosis.
View Article and Find Full Text PDFBackground: Despite strong recommendations in the latest guidelines for implementing guideline-directed medical therapy (GDMT) before discharge, there is a lack of data on the clinical characteristics and outcomes of older patients with heart failure (HF). Therefore, this study aimed to investigate the clinical characteristics and outcomes of patients with HF in a super-aging society during the GDMT era.
Methods And Results: In the COMPASS-HF study including 305 consecutive hospitalized patients, 177 with acute HF were identified through a medical record review.
Article Synopsis
- Subclinical leaflet thrombosis (SLT) can lead to failure of transcatheter heart valves (THV) after TAVI, prompting this study to investigate its formation and related thrombotic factors.
- In a study of 26 patients treated with edoxaban for atrial fibrillation undergoing TAVI, SLT was observed in 16.7% of patients at one week, decreasing to 5.9% by three months.
- It was found that patients with SLT at one week had reduced maximal leaflet thickness, while thrombogenicity initially dropped but began to rise again by three months post-TAVI, indicating complex dynamics in thrombus formation in the early recovery phase.
Aims: Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is often accompanied by atrial fibrillation (AF), atrial flutter (AFL), and atrial tachycardia (AT), which are difficult to control because beta-blockers and antiarrhythmic drugs can worsen heart failure (HF). This study aimed to investigate the outcomes of catheter ablation (CA) for AF/AFL/AT in patients with ATTRwt-CM and propose a treatment strategy for CA.
Methods And Results: A cohort study was conducted on 233 patients diagnosed with ATTRwt-CM, including 54 who underwent CA for AF/AFL/AT.
Background: Although the prevalence rate of valvular heart disease (VHD) is high in patients with systemic lupus erythematosus (SLE), the predictive factors of concomitant VHD have not been fully evaluated.
Methods And Results: Among 288 patients with SLE who underwent transthoracic echocardiography at Kumamoto University Hospital from 2016 to 2021, 241 patients with sufficient echocardiographic data were retrospectively analysed. Among them, 22 (9 %) had VHD (10 had mitral regurgitation, 3 had aortic regurgitation, 6 had tricuspid regurgitation, 1 had mitral regurgitation and tricuspid regurgitation, and 2 had a prosthetic cardiac valve).
Aims: The human epididymis protein 4 (HE4), a novel fibrosis marker, is expressed only in activated fibroblasts and is thought to reflect ongoing left ventricular (LV) fibrosis. LV fibrosis is a feature of severe aortic stenosis (AS) and is related to the post-operative outcome of patients with AS. We investigated the relationship between serum levels of HE4 and the post-operative prognosis of patients with severe AS.
View Article and Find Full Text PDFArticle Synopsis
- - This study analyzes the impact of right atrial strain during the reservoir phase (RASr) on the prognosis of patients with AL cardiac amyloidosis, finding that lower RASr values correlate significantly with higher mortality risk.
- - Among the 72 patients studied, those who died showed worse kidney function (eGFR), higher levels of biomarkers (BNP and hs-cTnT), and lower heart strain measurements (including RASr) compared to those who survived.
- - RASr was identified as a significant predictor of all-cause mortality even after accounting for other heart strain measures, highlighting its potential importance in assessing patient prognosis.
Article Synopsis
- This study looked at subclinical leaflet thrombosis after transcatheter aortic valve implantation (TAVI) in 35 patients, focusing on how thrombogenicity relates to this condition.
- Thrombogenicity was measured using a specific system (T-TAS) at several intervals before and after the TAVI procedure, revealing a decrease in thrombogenicity initially but improvement by 3 months.
- The research found a correlation between the decrease in thrombogenicity and an increase in leaflet thickness, suggesting that monitoring thrombogenicity could help predict the development of leaflet thrombosis post-TAVI.
Background: Patients with acute myocardial infarction (AMI) complicating renal dysfunction (RD) are recognized as being at high risk. Although diabetes mellitus (DM) is a major cause of RD, the prognostic impact of coexisting DM on mortality in patients with AMI complicating RD is ill-defined. This study compared the prognostic impact of coexisting DM in patients with AMI complicating RD according to both age and sex.
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- The study investigates the role of soluble PD-L1 (sPD-L1) in patients with coronary artery disease (CAD) and its potential link to cardiovascular events.
- Researchers measured sPD-L1 levels in 627 CAD patients and tracked their health outcomes over approximately 522 days.
- Results showed that higher sPD-L1 levels correlated with a greater rate of cardiovascular events, establishing sPD-L1 as a significant prognostic marker for CAD patients.
Article Synopsis
- A study compared a new deep learning algorithm, SR-DLR, to traditional reconstruction methods for assessing coronary stents in CT scans, focusing on image quality.
- The research included 24 patients with stents and used quantitative measures to analyze image sharpness and artifact presence.
- Results showed that SR-DLR significantly improved key metrics such as stent visibility and reduced image noise, leading to better diagnostic confidence among radiologists.
Background: Carpal tunnel syndrome (CTS) is considered an early sign of cardiac amyloidosis (CA) because amyloid deposition is often confirmed in the tenosynovium removed during carpal tunnel release (CTR); however, the prevalence of concomitant CA is unclear.
Methods and results: We prospectively examined 700 patients who underwent CTR and evaluated amyloid deposition after tenosynovium removal. Amyloid deposition was observed in 261 (37%) patients, who were significantly older and predominantly male (P<0.
Article Synopsis
- The study investigates factors that indicate the need for pacing device implantation (PDI) in patients with transthyretin amyloid cardiomyopathy (ATTR-CM), aiming to determine the role of preventive PDI and implantable cardioverter-defibrillator (ICD) implantation.
- It involved analyzing data from 114 wild-type and 50 hereditary ATTR-CM patients who were not implanted with pacing devices at diagnosis, comparing backgrounds of those who needed future PDI and identifying specific conduction disturbances linked to these needs.
- Findings suggest that bifascicular block is a significant predictor for PDI in both types of ATTR-CM, while first-degree AV block does not necessitate PDI or ICD; the need for larger studies is
Article Synopsis
- The study investigates the relationship between Japanese high bleeding risk criteria (J-HBR), thrombogenicity, and bleeding events in patients undergoing percutaneous coronary intervention (PCI) through a retrospective analysis of 300 patients.
- It categorizes patients into three groups based on their J-HBR status and finds that a high J-HBR score is linked to lower thrombogenicity and an increased incidence of bleeding events within a year.
- The findings suggest that a J-HBR-positive/high status indicates both low thrombus formation and a higher risk of bleeding complications post-PCI.
Article Synopsis
- The study investigates the "obesity paradox," where overweight/obesity is linked to both improved and worsened survival outcomes in heart failure (HF) and coronary artery disease (CAD), particularly among patients with acute myocardial infarction (AMI).
- It analyzed data from 7,265 AMI patients, categorizing HF severity using the Killip classification and found that overweight/obesity decreased in-hospital mortality for patients with mild HF but increased risk for those with severe HF.
- The results highlight that the impacts of overweight/obesity vary significantly with HF severity, pointing toward a negative effect as HF worsens, indicating a need for careful management of weight in these patients.
Article Synopsis
- Alcohol is a known risk factor for atrial fibrillation (AF), and variants of the aldehyde dehydrogenase 2 (ALDH2) gene, which affect alcohol metabolism, are common among East Asians.
- A study investigated the link between AF and ALDH2 variants in 656 patients, finding that those with the deficient variant who consumed alcohol had a significantly higher risk of developing AF.
- The results suggested that while the ALDH2 variant itself was not directly linked to AF incidence, carriers who habitually consumed alcohol faced increased risk, indicating that avoiding alcohol may help prevent AF in these individuals.
Transcatheter Edge-to-Edge Repair for Atrial Secondary Mitral Regurgitation.
JACC Cardiovasc Interv
September 2022
Background: Atrial secondary mitral regurgitation (ASMR) is a subtype of SMR that has a poor prognosis, and thus far, evidence of the therapeutic options for the management of ASMR is limited.
Objectives: This study aimed to investigate the effectiveness of transcatheter edge-to-edge repair (TEER) for ASMR.
Methods: The study retrospectively analyzed consecutive patients who underwent MitraClip at the Heart Center Bonn.
Article Synopsis
- * Researchers examined 140 patients with severe AS, analyzing a total of 164 vascular segments and categorizing them into four groups based on their FFR and iFR measurements.
- * They found that 29.3% of cases exhibited discordance, predominantly negative discordance (where iFR is lower but FFR is higher), particularly in the left anterior descending artery and when peak velocity was 5.0 m/s or more.
Aims: Inflammatory activation of leukocytes may limit prognosis of patients (pts) with severe aortic valve stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). Leukocyte telomere length (LTL) is a marker of proliferative capacity and inflammatory responsiveness but the impact of LTL on the prognosis in AS remains elusive. The aim of this study was to analyse the association of LTL with inflammatory markers and prognosis of pts undergoing TAVR.
View Article and Find Full Text PDFBackground: The paradoxical association of obesity with mortality, named the "obesity paradox", has been inconsistent, possibly due to a difference between body mass index (BMI) and central obesity, estimated by waist circumference (WC) as patterns of adiposity.
Subjects/methods: We enrolled 8513 participants from the Kumamoto Intervention Conference Study, a multicenter registry that included consecutive patients undergoing percutaneous coronary intervention (PCI) at 18 centers between 2008 and 2017 in Japan. Patients were divided into quartiles in ascending order of the BMI or WC.
Background: We aimed to clarify the predictive factors for left ventricular (LV) function after aortic valve replacement (AVR) in patients with aortic regurgitation (AR).
Methods And Results: Among 555 patients who underwent AVR at our institution from January 2015 to December 2020, we enrolled 44 patients for whom only AVR (or AVR + aortic replacement) was performed. We defined LV dysfunction under any of the following criteria: LV ejection fraction (LVEF) <50 %, LV diastolic dimension >65 mm, LV systolic dimension (LVDs) >50 mm, or LVDs/body surface area > 25 mm/m2.
Article Synopsis
- The study investigates how left atrial (LA) and left ventricular (LV) functions measured by 2D speckle tracking echocardiography can help identify transthyretin amyloid cardiomyopathy (ATTR-CM) in patients with aortic stenosis (AS).
- Out of 72 patients analyzed, 16 tested positive for ATTR-CM via Tc-PYP scintigraphy, showing notable differences in troponin levels and echocardiography parameters between the positive and negative groups.
- Key findings indicated that specific echocardiographic measures, particularly peak longitudinal strain rate in LA and relative apical longitudinal strain index, could significantly predict the presence of ATTR-CM, with certain sensitivity and specificity values, suggesting their potential utility