Publications by authors named "Saji M"
Background: A small mitral valve area (MVA) is one of the challenging anatomies for transcatheter edge-to-edge repair (TEER) for mitral regurgitation, but the relationship between baseline MVA and clinical outcomes remains unknown. This study aimed to evaluate the association of baseline MVA with procedural and clinical outcomes in patients undergoing TEER with MitraClip from the OCEAN-Mitral registry (Optimized Catheter Valvular Intervention-Mitral).
Methods: A total of 1768 patients undergoing TEER were divided into 3 groups according to baseline MVA: group 1: <4.
Background: Research on the impact of angiographically detected residual trabeculation after left atrial appendage closure (LAAC) is limited.
Objectives: To investigate the incidence, characteristics, and clinical implications of angiographically detected residual trabeculation after LAAC using the WATCHMAN device.
Methods: We analyzed 1350 consecutive patients with atrial fibrillation undergoing LAAC using the WATCHMAN device from the OCEAN-LAAC registry, which is a prospective ongoing, multicenter Japanese registry.
Article Synopsis
- This study explores the relationship between handgrip strength and all-cause mortality in patients undergoing transcatheter edge-to-edge repair (TEER) for heart issues, suggesting that weaker grip strength could indicate a higher risk of death post-procedure.
- It includes data from the OCEAN-Mitral Registry, which analyzed handgrip tests of 2077 patients before TEER, with follow-ups showing varied changes in strength based on the success of the procedure.
- The findings suggest that improving mitral regurgitation (MR) post-TEER can positively impact frailty and resilience, making this research a significant insight into patient outcomes in heart-related treatments.
Article Synopsis
- This study examined how left ventricular ejection fraction (LVEF) changes after a specific heart valve repair procedure called transcatheter edge-to-edge valve repair (TEER) in patients with mitral regurgitation (MR).
- Findings revealed that 32% of patients experienced worsened LVEF after the procedure, linked to increased end-systolic volumes in the heart and certain predictors like higher LVEF and levels of B-type natriuretic peptide.
- Despite the LVEF worsening, long-term outcomes (like death or hospitalization for heart failure) were similar for both patients with worsened and preserved LVEF, indicating that LVEF change might not significantly impact overall health results post-TEER
Patients with epilepsy often require long-term treatment with antiseizure medications, and their impact on daily activities, particularly driving, is of significant concern. The recently published "Guideline for Evaluating Effects of Psychotropic Drugs on the Performance to Drive a Motor Vehicle" in Japan provides a framework that can be referred to for not only the evaluation of new drugs but also the reevaluation of approved drugs. This study conducted a literature review regarding the effects of carbamazepine, valproate, lamotrigine, lacosamide, and levetiracetam, which are frequently prescribed for epilepsy, on driving performance following the guideline's tiered evaluation approach.
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- Percutaneous left atrial appendage closure (LAAC) helps reduce stroke and bleeding events in patients with non-valvular atrial fibrillation, particularly those who cannot take anticoagulants, but patients with heart failure remain at risk.
- In a study involving 937 patients, researchers evaluated the effect of baseline plasma B-type natriuretic peptide (BNP) levels on outcomes after LAAC, with 98% of the procedures being successfully completed.
- Results showed that higher baseline plasma BNP levels were linked to an increased risk of stroke, bleeding events, and mortality, indicating the need for further research to optimize treatment strategies for these patients.
Background: The Clinical Frailty Scale (CFS) is a useful frailty marker for predicting clinical outcomes in patients undergoing invasive therapy. However, the clinical impact of CFS after transcatheter edge-to-edge repair in patients with mitral regurgitation (MR) remains unclear. This study aimed to elucidate the association between the baseline frail status defined by the CFS and clinical outcomes with or without postprocedural MR ≥2+ (post-MR ≥2+) after transcatheter edge-to-edge repair.
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- A history of hospitalization for heart failure (HHF) before transcatheter aortic valve implantation (TAVI) is linked to poorer clinical outcomes in patients with severe aortic stenosis (AS).
- In a study of 2,752 patients, those with prior HHF had significantly higher 30-day mortality and overall risk of negative outcomes compared to those without such a history.
- The findings highlight that prior HHF affects patients regardless of their heart function, emphasizing the need for careful evaluation and management in these cases post-TAVI.
Article Synopsis
- * Out of 1474 patients analyzed, 18.4% received higher doses of beta-blockers one month post-surgery, showing a significant association with lower risks of all-cause and cardiovascular mortality.
- * The findings suggest that adjusting beta-blocker therapy after M-TEER can lead to improved outcomes, particularly for patients with a low left ventricular ejection fraction (LVEF) of 40% or less.
Article Synopsis
- - The study investigates how mismatched residual mitral regurgitation (MR) and left atrial pressure (LAP) after a specific heart procedure (TEER) can negatively impact clinical outcomes in patients with severe MR and heart failure.
- - Researchers categorized 1,477 patients into three groups based on their MR and LAP levels, finding that those with mismatched or poor conditions faced higher risks of death and heart failure hospitalization compared to those in an optimal state.
- - Six key factors were identified as predictors of hemodynamic mismatch after TEER, including body mass index and pre-procedural pressures, suggesting that monitoring these could help improve patient outcomes.
Article Synopsis
- The study evaluates the outcomes of mitral transcatheter edge-to-edge repair (M-TEER) in patients with severe mitral regurgitation, focusing on the impact of body mass index (BMI) on mortality rates.
- Researchers analyzed data from 2,149 M-TEER patients, categorizing them as underweight, normal weight, or overweight/obese, finding that underweight individuals had significantly higher rates of all-cause, cardiovascular, and non-cardiovascular mortality.
- The findings suggest that underweight status is a critical risk factor for worse outcomes post-M-TEER, highlighting the importance of thorough risk assessment and management in these patients.
Article Synopsis
- The study focuses on enhancing deep neural network algorithms in medical applications, particularly in electrocardiography (ECG) analysis for detecting left ventricular systolic dysfunction (LVSD).
- Researchers applied self-supervised learning through masked autoencoders (MAEs) and pretrained Vision Transformer (ViT) models using limited ECG data from The University of Tokyo Hospital.
- The MAE-based models achieved significantly better performance in detecting LVSD compared to other methods, showing strong results across multiple external validation datasets and maintaining high accuracy on benchmark datasets.
Article Synopsis
- This study examines the effects of percutaneous left atrial appendage closure (LAAC) on left atrial volume index (LAVI) and its implications for patients with atrial fibrillation (AF).* -
- Researchers analyzed 225 patients and found no overall significant change in LAVI six months after LAAC, but some patients did experience increases, particularly those with smaller baseline LAVI and higher tricuspid regurgitation pressure.* -
- An increase in LAVI was linked to a higher risk of heart failure hospitalization, especially in patients with a baseline LAVI greater than 55 ml/m.*
Although takotsubo syndrome (TTS) is characterized by transient systolic dysfunction of the left ventricle (LV), the time course and mechanism of LV function recovery remain elusive. The aim of this study is to evaluate cardiac functional recovery in TTS via serial cardiac magnetic resonance feature tracking (CMR-FT). In this Japanese multicenter registry, patients with newly diagnosed TTS were prospectively enrolled.
View Article and Find Full Text PDFPort-site metastasis (PSM) is rare following laparoscopic gastrectomy for gastric cancer. Previous reports focused on localized lesions treated with excision; contrastingly, case reports describing extensive invasion into the lower extremity skeletal muscles causing deterioration in activities of daily living are nonexistent. A 55-year-old male underwent a laparoscopic distal gastrectomy for gastric cancer.
View Article and Find Full Text PDFBackground: The comparative efficacy and safety of adjusted- and standard-dose prasugrel in East Asian patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) remain unclear. This study aimed to comparatively assess the ischaemic and bleeding outcomes of adjusted-dose (maintenance dose: 3.75 mg) and standard-dose (maintenance dose: 10 mg) prasugrel in East Asian patients with AMI undergoing PCI.
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- This study analyzed outcomes of two types of left atrial appendage closure devices, WATCHMAN FLX (WM-FLX) and WATCHMAN-2.5 (WM2.5), in 1,464 Asian patients from a Japanese registry.
- WM-FLX showed significantly higher procedural success rates and lower rates of complications like pericardial effusion compared to WM2.5.
- Additionally, the WM-FLX group experienced substantially lower cumulative bleeding rates at one year, especially during the first six months post-procedure, indicating its potential advantages in safety.
Low body weight and advanced age are among the best predictors of osteoporosis. Osteoporosis Self-Assessment Tool (OST) values are calculated by a simple formula [(body weight in kilograms - age in years) × 0.2] to identify patients at increased risk of osteoporosis.
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- The study investigates heart failure incidence and outcomes in patients who survived an acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention.
- Out of 3,411 AMI patients, 124 (3.8%) were admitted for heart failure, with significant factors including age, sex, and heart function at admission.
- The heart failure group experienced significantly higher rates of all-cause mortality and major cardiovascular events compared to those without heart failure admissions (11.3% vs. 2.5% for mortality).
Background: The extent of cardiac damage and its association with clinical outcomes in patients undergoing transcatheter edge-to-edge repair (TEER) for degenerative mitral regurgitation remains unclear. This study was aimed to investigate cardiac damage in patients with degenerative mitral regurgitation treated with TEER and its association with outcomes.
Methods: We analyzed patients with degenerative mitral regurgitation treated with TEER in the Optimized Catheter Valvular Intervention-Mitral registry, which is a prospective, multicenter observational data collection in Japan.
In December 2022, the Ministry of Health, Labour and Welfare (MHLW) of Japan issued and implemented the guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance. This guideline recommends the use of a tiered approach to assess clinically meaningful driving impairment. It is noted that adverse events cannot be solely explained by pharmacokinetics, as the onset and duration of these events vary.
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- Transcatheter edge-to-edge mitral valve repair (TEER) is gaining attention as a treatment for significant secondary mitral regurgitation, especially in patients with chronic heart failure.* -
- The study analyzed 1,517 patients from the OCEAN-Mitral registry to identify factors linked to cardiac death within a year following TEER, finding that previous heart failure admissions, use of intravenous inotropes, and high plasma B-type natriuretic peptide levels were significant predictors.* -
- Researchers created a new risk-scoring system based on these factors, successfully distinguishing different levels of 1-year cardiac mortality risk (16%, 8%, and 4%), which can help clinicians tailor treatment strategies.*
Article Synopsis
- Transcatheter edge-to-edge repair (TEER) with MitraClip is a minimally invasive treatment for mitral regurgitation (MR), but comprehensive data on its safety and effectiveness is limited, especially for the fourth-generation (G4) system.
- The OCEAN-Mitral Registry, involving 21 centers in Japan, enrolled 2,150 patients with MR to analyze their characteristics, procedural details, and clinical outcomes between April 2018 and June 2021.
- Findings indicated that 94.6% of patients achieved acute procedural success with both the G2 and G4 systems, although the G4 system showed promise for improved outcomes with a multidisciplinary approach.
Article Synopsis
- This study analyzed the effects of polyvascular disease (PolyVD) in patients who experienced acute myocardial infarction (AMI) after undergoing modern heart procedures (PCI).
- It included data from 3,411 AMI patients, categorizing them based on whether they had complications like stroke or peripheral artery disease, revealing higher death rates and adverse events for those with PolyVD.
- The findings suggest that having PolyVD is linked to significantly worse health outcomes, such as increased risk of death, major cardiovascular events, and bleeding issues.