Publications by authors named "Sayuki Kobayashi"

Aim: We aimed to determine whether baseline high-density lipoprotein (HDL) cholesterol efflux capacity (CEC) at the time of coronary angiography (CAG) could serve as a prognostic marker for future major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD) through a systematic review and meta-analysis.

Methods: The MEDLINE, Cochrane, and Embase databases were used for data collection. As of April 2024, 2,871 studies have been identified.

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  • Balloon-based catheter ablation is an effective treatment for atrial fibrillation (AF) that creates continuous lesions for pulmonary vein isolation and relies less on the operator's skill than traditional methods.
  • * Cryoballoon ablation is widely used globally, offering comparable efficacy and safety to standard radiofrequency ablation, while hot balloon ablation, developed in Japan, produces larger lesions and features oesophageal cooling.
  • * Laser balloon ablation allows for direct visualization and automated ablation, enhancing the speed and effectiveness of achieving pulmonary vein isolation.*
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  • - The systematic review and meta-analysis assessed the effectiveness of paclitaxel-coated balloon angioplasty (PCB) for treating new lesions in patients with acute coronary syndrome (ACS) versus drug-eluting stents (DES).
  • - They analyzed nine studies involving over 2,000 cases, finding that the major adverse cardiac event (MACE) rates were similar between PCB (8.42%) and DES (10.62%) groups, with no significant differences in several health outcomes.
  • - The results suggest that PCB angioplasty is a feasible alternative to DES for managing de novo lesions in ACS patients during emergency procedures, with comparable midterm outcomes.
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  • * A study involving 91 patients undergoing RHB ablation for persistent atrial fibrillation showed significant reductions in both LA volume and EAT volume after 6 months.
  • * Both obese and non-obese patients experienced similar EAT reductions in the pulmonary vein region, and the RHB ablation produced deep lesions affecting EAT, indicating potential long-term changes, but further research is needed to understand its full impact on treatment success.
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  • Atrial septal defect (ASD) is often underdiagnosed due to subtle symptoms, but a new screening approach using convolutional neural networks (CNN) can enhance early detection through analysis of electrocardiography (ECG) data.
  • The study analyzed 671,201 ECGs from patients at three hospitals to train a CNN model, achieving a strong area under the receiver operating characteristic curve (AUROC) of 0.85-0.90 for ASD detection.
  • The proposed screening method significantly improved sensitivity from 80.6% to 93.7%, demonstrating its effectiveness across various patient subgroups while maintaining specific criteria.
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Purpose: Isovolumic relaxation time (IVRT) is a useful indicator of diastolic dysfunction. However, a measurement method for IVRT has not been established. The Dual Gate Doppler method, which can record two separate pulse-wave Doppler signals simultaneously using two sample gates, may be ideal for measuring IVRT.

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The prognostic impact of CHADS, CHADS-VASc, and CHADS-VASc-HS scores on clinical outcomes after drug-eluting stent (DES) placement has not been fully elucidated. The present study was a retrospective, non-randomized, single-center, and lesion-based study. Target lesion failure (TLF), comprising cardiac death, non-fatal myocardial infarction, and target vessel revascularization, occurred in 7.

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  • A retrospective study was conducted to compare the effectiveness of paclitaxel-coated balloon (PCB) angioplasty versus drug-eluting stents (DESs) for treating new blockages in large coronary vessels.
  • Out of 154 patients treated, the incidence of target lesion failure (TLF) was similar between the PCB group (6.8%) and the DES group (14.6%), indicating that PCB is as effective as DESs in preventing serious cardiac events.
  • Angiographic results showed no significant cases of restenosis (re-narrowing) following PCB treatment, suggesting it may be a promising option for coronary interventions without negative outcomes.
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Background: Prader-Willi syndrome (PWS) is suspected at birth if extreme hypotonia, difficulty in feeding, hypogonadism, and failure to thrive are present. Genetic diagnosis of PWS can generally be made within the first few months of life; however, a delayed diagnosis of PWS is frequently reported. Although the clinical characteristics of perinatal and neonatal patients with PWS have been reported, there are no such reports on the clinical characteristics of these patients in Japan.

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  • The study investigates the safety and effectiveness of drug-coated balloon (DCB) angioplasty compared to drug-eluting stents (DESs) for treating coronary stenosis, involving 588 patients treated between 2016 and 2019.
  • Overall target lesion failure (TLF) rates were similar between the DCB group (9.6%) and DES group (10.2%), indicating comparable clinical safety.
  • Additionally, the angiographic restenosis rates were not significantly different: DCB at 6.3% and DES at 10.1%, with late lumen enlargement identified as a predictor for better outcomes in DCB treatments.
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  • Preventing phrenic nerve injury (PNI) during balloon-based ablation is crucial, as the phrenic nerve is located near the SVC-RA junction where the ablation takes place.
  • A study compared cryoballoon ablation (CBA) and hot-balloon ablation (HBA) in patients with atrial fibrillation, revealing that CBA led to a higher incidence of transient PNI (7.3% vs 1.1%) but all cases were temporary.
  • CBA created larger and more frequent lesions at the SVC-RA junction compared to HBA, suggesting that the design and positioning of the balloon systems play a significant role in the extent of damage to surrounding structures
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  • The study explored whether fully circumferential lesions are necessary for achieving pulmonary vein isolation (PVI) during laser balloon ablation, especially considering potential complications like stenosis.
  • In a trial with 51 patients, researchers found that 39% of PVs achieved early PVIs with significantly better success in lower PVs compared to upper PVs (60.1% vs. 17.6%).
  • The results suggest that additional research is needed to understand the energy requirements for lower PVs to prevent chronic narrowing, as energy delivery was less for lower PVs yet stenosis rates were similar for both upper and lower PVs after 6 months.
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Transcatheter edge-to-edge repair (TEER) is becoming the standard invasive treatment for ventricular functional mitral regurgitation (MR). It is necessary to determine the severity of MR before treatment with MitraClip; however, the severity of secondary MR is usually underestimated compared with that of primary MR and varies temporally. Therefore, to accurately determine the severity of MR, it is important to correctly use the algorithm of the guidelines for valvular heart disease and aggressively perform stress echocardiography.

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  • The study investigates the cardiovascular health of adults with Prader-Willi syndrome (PWS), focusing on potential causes of their high mortality rate.
  • Researchers analyzed 18 adults with PWS, measuring various cardiac function indicators and assessing levels of cardiovascular biomarkers.
  • Findings revealed common comorbid conditions like obesity, diabetes, and hypertension, and although overall cardiac function appeared normal, subtle cardiovascular abnormalities were noted, emphasizing the need for better management of obesity-related issues in these patients.
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Introduction: Cryoablation has emerged as an alternative to radiofrequency ablation for treating atrioventricular nodal reentrant tachycardia (AVNRT). The aim of this prospective study was to evaluate the efficacy and safety of cryoapplication at sites within the mid/high septal region of Koch's triangle and the relation between sites of transient AV block (AVB) and sites of successful cryoablation.

Methods And Results: Included were 45 consecutive patients undergoing slow-fast AVNRT cryoablation.

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Introduction: A new hot balloon system that registers balloon surface temperature (BST) during energy delivery is now available for clinical use in Japan. This study sought to investigate the utility of BST measurement for achievement of pulmonary vein isolation (PVI) by a single-shot energy delivery strategy during hot balloon ablation (HBA).

Methods: We applied and tested the system in 30 consecutive patients undergoing HBA for paroxysmal or early-persistent atrial fibrillation (AF).

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Introduction: Hot-balloon ablation depends solely on thermal conduction, and myocardial tissue is ablated by only conductive heating from the balloon surface. Despite growing clinical evidence of the efficacy and safety of hot-balloon ablation for atrial fibrillation (AF), the actual tissue temperature and the mechanism of heating during such ablation has not been clarified. To determine, by means of a porcine study, the temperatures of tissues targeted during hot-balloon ablation of AF performed with hot-balloon set temperatures of 73°C or 70°C, in accordance with the temperatures now used clinically.

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Background: Tricuspid annuloplasty for tricuspid regurgitation (TR) depends on the measurements of tricuspid annular diameter (TAD) obtained in an apical four-chamber view on two-dimensional (2D) transthoracic echocardiography (TTE). We performed a combined 2D and three-dimensional (3D) echocardiographic study to understand the impact of the size, shape, and orientation of a dilated annulus on the inconsistencies between measured 2D TTE-TAD and the actual annular diameter.

Methods: A total of 185 patients with grade ≥3+ TR and 50 controls underwent 2D TTE and 3D transesophageal echocardiography (TEE) assessment of the tricuspid valve.

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Background: The aim of this study was to examine the reduction in the atrial conduction time during the follow-up phase of catheter ablation in persistent atrial fibrillation (PsAF) patients, which would suggest atrial reverse remodeling, and to investigate its impact on predicting AF recurrence.

Methods: Fifty-seven PsAF patients underwent radiofrequency catheter ablation. The P-wave to left atrial appendage (LAA) conduction time was measured by transthoracic echocardiography using tissue Doppler imaging (P-LAA TDI), within 24 h and 6 months after ablation.

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  • The study investigated residual conduction gaps that occur in patients with atrial fibrillation (AF) after treatment with HotBalloon-based wide antral ablation (HBWA).
  • Ultra-high-resolution mapping was used on 55 patients, revealing that 47% had residual gaps, primarily in the left superior pulmonary veins.
  • The identified gaps had lower electrical activity and were relatively short, but were effectively addressed with targeted follow-up ablation procedures.
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Background: The reduction in the left atrial appendage (LAA) flow velocity is related to the presence of emboli in atrial fibrillation (AF) patients. The LAA is located on the left superior side of the left atrial (LA) anterior wall, and we investigated the relationship between the reduction in the LAA flow velocity (LAAFV) and low voltage zones (LVZs < 0.5 mV) on the LA anterior wall.

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Aims: Percutaneous edge-to-edge repair alters mitral valve (MV) geometry in functional mitral regurgitation (FMR). We sought to characterize MV morphology in patients with central and eccentric FMR, compare the geometrical effect of MitraClip therapy, and elucidate different mechanisms of MR improvement according to FMR subtypes.

Methods And Results: Seventy-six symptomatic patients with Grade 3 to 4+ FMR (central, n = 39; eccentric, n = 37) underwent three-dimensional transoesophageal echocardiography during MitraClip implantation.

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