Publications by authors named "Seiji Takashio"

Background: The Japanese Hypertrophic Cardiomyopathy Registry Study was designed to provide comprehensive, real-world insights into the clinical characteristics and management of hypertrophic cardiomyopathy (HCM) in Japan.

Methods: This multicentre, prospective study enrolled consecutive patients with HCM from 24 referral hospitals across Japan starting in 2016. The baseline characteristics of 1485 patients enrolled by December 2019 are presented in this analysis.

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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.

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Transthyretin amyloid cardiomyopathy (ATTR-CM) is becoming increasingly recognized with the aging population, advancements in understanding of disease pathobiology and the potential benefits of emerging therapies. Bone scintigraphy, including Tc-labeled pyrophosphate scintigraphy, is currently considered the first-line modality for identifying ATTR-CM. Therefore, it is important to increase the preset probability using inexpensive and simple tests including echocardiography.

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Tafamidis is the only currently available disease-modifying agent for transthyretin amyloid cardiomyopathy (ATTR-CM); however, reports on its long-term efficacy, safety, and longitudinal cardiac parameter outcomes are lacking. Herein, we present 2 cases of wild-type ATTR-CM receiving tafamidis for 9 years, in which serial long-term follow-up data were obtained. In both cases, tafamidis treatment was continued without any adverse effects, and no hospitalization due to heart failure occurred.

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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 cut-off 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 99 m 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).

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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.

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Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is a progressive and infiltrative cardiac disorder that may cause fatal consequences if left untreated. The estimated survival time from diagnosis is approximately 3-6 years. Because of the non-specificity of initial symptom manifestation and insufficient awareness among treating physicians, approximately one-third of patients with ATTRwt-CM are initially misdiagnosed with other cardiac diseases.

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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.

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Article Synopsis
  • The study investigates factors impacting the age of onset of wild-type transthyretin amyloidosis cardiomyopathy (ATTRwt-CM) in the elderly, focusing on amyloid deposition in heart tissue using Tc-pyrophosphate (PYP) imaging and clinical data.
  • A cohort of 107 diagnosed ATTRwt-CM patients underwent PYP scintigraphy, and statistical analyses identified significant predictors for age of onset, notably the heart-to-contralateral (H/CL) ratio, hemoglobin (Hb), and creatinine (Cr) levels.
  • Results indicate that the H/CL ratio has an inverse relationship with age of onset, suggesting it could influence heart failure development, especially in patients with anemia and kidney issues.
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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).

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  • Atrial amyloidosis is linked to amyloid deposition of atrial natriuretic peptide (ANP) and transthyretin (TTR), with TTR being the main protein associated with cardiac amyloidosis.
  • A 73-year-old man with heart failure, atrial fibrillation, and severe mitral regurgitation was diagnosed with ATTR-CM after various tests showed signs of cardiac amyloidosis, leading to surgical interventions.
  • Histological analysis revealed coexisting ANP and TTR amyloid deposits in the left atrial tissue, suggesting both contribute to the development of atrial amyloidosis and increase the risk of atrial fibrillation.
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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.

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Background: Although tafamidis treatment improves prognosis in patients with wild-type transthyretin amyloid cardiomyopathy, an optimal surrogate marker monitoring its therapeutic effect remains unclear. This study investigated the association between changes in cardiac biomarkers, high-sensitivity cardiac troponin T (hs-cTnT) and B-type natriuretic peptide (BNP) during the first year after tafamidis treatment and clinical outcomes.

Methods And Results: In 101 patients with wild-type transthyretin amyloid cardiomyopathy receiving tafamidis at our institution, change in cardiac biomarkers from baseline to 1 year after tafamidis administration and its association with composite outcomes (composite of all-cause death and hospitalization attributable to heart failure) was assessed.

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To assess the diagnostic performance of unenhanced electrocardiogram (ECG)-gated cardiac computed tomography (CT) for detecting myocardial edema, using MRI T2 mapping as the reference standard. This retrospective study protocol was approved by our institutional review board, which waived the requirement for written informed consent. Between December 2017 to February 2019, consecutive patients who had undergone T2 mapping for myocardial tissue characterization were identified.

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Aims: This study aims to evaluate the distribution of extracellular volume fraction detected via computed tomography, clinical characteristics of high extracellular volume fraction detected via computed tomography, and the rate of incidental detection of cardiac amyloidosis in patients undergoing cardiac computed tomography for coronary artery evaluation.

Methods And Results: This study included 874 consecutive patients (mean age, 74.4 ± 7.

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Neither the efficacy nor safety of elobixibat has been investigated in the treatment of chronic constipation in patients with heart failure (HF). In this prospective, single-center, single-arm study elobixibat (10 mg/day) was administered for 12 weeks to 18 HF patients with chronic constipation defined according to the Rome IV criteria. Spontaneous bowel movement (SBM), stool consistency as measured by the Bristol Stool Form Scale, and degree of straining during defecation were recorded.

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Article 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.
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  • Portopulmonary hypertension (PoPH) is a serious complication linked to portal hypertension, especially in patients with liver cirrhosis, but is often underdiagnosed due to the variety of symptoms like dyspnea.
  • A comprehensive case study highlights the use of advanced imaging techniques, including dual energy CT and pulmonary perfusion imaging, to effectively diagnose PoPH.
  • This refined imaging protocol provides a noninvasive, efficient way to evaluate PoPH, complementing standard chest evaluations.
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  • 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.
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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.
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  • The study evaluated the effectiveness of cardiac MRI T1 and T2 mapping as imaging biomarkers for transthyretin amyloid cardiomyopathy (ATTR-CM) in 74 patients.
  • The researchers found that extracellular volume fraction (ECV) strongly correlated with native T1 and other disease parameters, particularly in patients without myocardial edema.
  • The findings suggest that while ECV can be a useful biomarker for monitoring ATTR-CM, the presence of myocardial edema complicates its interpretation.
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  • The study compared the efficacy of computed tomography (CT) and cardiac magnetic resonance (CMR) in measuring myocardial extracellular volume (ECV) in patients with cardiac amyloidosis (CA).
  • Both modalities showed similar mean global ECVs, with strong correlations between CT-ECV and CMR-ECV across various heart segments.
  • Findings suggest that CT can effectively serve as a practical alternative to CMR for assessing ECV in a clinical setting, providing valuable insights related to patient status.
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