Publications by authors named "Shigeki Kimura"
Article Synopsis
- Recent studies indicate that calcified nodules (CN) in patients with acute coronary syndrome (ACS) are linked to worse health outcomes.
- The study involved 695 ACS patients and found that those with OCT-defined CN were typically older and had higher incidences of diabetes, hemodialysis, and severe heart failure compared to those without CN.
- Key predictors for the presence of OCT-CN included age, hemodialysis, and Killip Class III/IV heart failure, suggesting that these factors could indicate increased lesion severity and poorer prognosis for ACS patients.
: Single-photon emission computed tomography (SPECT) encounters difficulties in diagnosing severe multi-vessel coronary artery disease (svMVD) because of balanced ischemia. We estimated the predictive value of electrocardiogram-gated SPECT for svMVD and improved it using machine learning (ML). : We enrolled consecutive 335 patients (median age, 74 years; 255 men) who underwent adenosine stress-gated SPECT (Technesium) and coronary angiography.
View Article and Find Full Text PDFWe aimed to develop machine learning-based predictive models for identifying inappropriate implantable cardioverter-defibrillator (ICD) therapy. Our study included 182 consecutive cases (average age 62.2 ± 4.
View Article and Find Full Text PDFBackground The prognostic impact of optical coherence tomography-diagnosed culprit lesion morphology in acute coronary syndrome (ACS) has not been systematically examined in real-world settings. Methods and Results This investigator-initiated, prospective, multicenter, observational study was conducted at 22 Japanese hospitals to identify the prevalence of underlying ACS causes (plaque rupture [PR], plaque erosion [PE], and calcified nodules [CN]) and their impact on clinical outcomes. Patients with ACS diagnosed within 24 hours of symptom onset undergoing emergency percutaneous coronary intervention were enrolled.
View Article and Find Full Text PDFArticle Synopsis
- Outcomes after heart attacks in women are still not great, and understanding the connection between risk factors and artery plaque types is limited.
- A study of 382 women with acute coronary syndrome showed that younger women (<60 years) mostly had plaque erosion, while older women had different plaque characteristics.
- Risk factors like smoking, diabetes, and high cholesterol affect plaque development, indicating that addressing these issues early, especially in young women, could help prevent worsening heart disease as they age.
Article Synopsis
- The ATLAS-OCT trial aims to investigate the feasibility of using optical coherence tomography (OCT) to guide primary percutaneous coronary intervention (PCI) in patients with STEMI, given the ongoing risks of adverse events even after successful revascularization.
- The study will enroll all STEMI patients who undergo primary PCI at specific hospitals known for their expertise in OCT, regardless of whether OCT is utilized during the procedure.
- The primary goal is to evaluate how frequently OCT imaging can be successfully conducted during PCI, along with tracking major adverse cardiac events over the course of one year.
Background: Coronary healed plaques (HPs) reportedly have high vulnerability or show advanced atherosclerosis and a risk of rapid plaque progression. However, the prognosis of stable angina pectoris (SAP) patients with HPs undergoing percutaneous coronary intervention (PCI) remains under-investigated.
Methods and results: We analyzed 417 consecutive lesions from SAP patients undergoing pre- and post-intervention optical coherence tomography (OCT) for which HPs were defined as having a layered appearance.
Background: Qualitative differences in 12-lead electrocardiograms (ECG) at onset have been reported in patients with takotsubo syndrome (TTS) and acute anterior myocardial infarction (Ant-AMI). We aimed to distinguish these diseases by machine learning (ML) approach of microvolt-level quantitative measurements.
Methods: We enrolled 56 consecutive patients with sinus rhythm TTS (median age, 77 years; 16 men), and 1-to-1 random matching was performed based on age and sex of the patients.
Background: Recent retrospective investigations have suggested that optical coherence tomography (OCT) enables the diagnosis of underlying acute coronary syndrome (ACS) causes such as plaque rupture, plaque erosion, and calcified nodule. The relationships of these etiologies with clinical outcomes, and the clinical utility of OCT-guided primary percutaneous coronary intervention (PCI) are not systematically studied in real-world ACS treatment settings.
Methods: The TACTICS registry is an investigator-initiated, prospective, multicenter, observational study to be conducted at 21 hospitals in Japan.
Article Synopsis
- Recent research reveals that while cardiovascular mortality in women has decreased, the differences in the causes of acute coronary syndromes between sexes are not well-understood.
- A study analyzing 1,368 patients showed that both men and women had similar types of plaque morphology, but significant differences in the mechanisms leading to these conditions emerged with age.
- Specifically, older women exhibited an increasing tendency toward plaque rupture and vulnerability features, unlike their male counterparts, suggesting that age plays a crucial role in the sex-related differences observed.
Article Synopsis
- Optical Coherence Tomography (OCT) has evolved as a key imaging tool over the past two decades, significantly improving our understanding of coronary atherosclerosis and optimizing cardiac interventions.
- Recent advancements in OCT have enabled better identification of plaque pathology and healing processes in patients with acute coronary syndromes, potentially transforming patient management.
- This Review aims to present the latest insights on cardiac OCT, standardizing its clinical application and interpretation among researchers and clinicians globally.
Background A recent study reported that the outcome of patients with plaque erosion treated with stenting is poor when the underlying plaque is lipid rich. However, the detailed phenotype of patients with plaque erosion, particularly as related to different age groups, has not been systematically studied. Methods and Results Patients with acute coronary syndromes caused by plaque erosion were selected from 2 data sets.
View Article and Find Full Text PDFBackground: Non-obstructive general angioscopy (NOGA) can be used to diagnose aortic atherosclerotic plaques. We examine the association between the number of aortic plaques detected by NOGA and the risk of subsequent cardiovascular events.
Methods: The Evaluation of AtheroScleroTic and rupture events by Non-Obstructive General Angioscopy (EAST-NOGA) was a prospective cohort study of patients with suspected coronary artery disease who underwent NOGA.
Optical coherence tomography and coronary angioscopy assessment of healed coronary plaque components.
Int J Cardiovasc Imaging
October 2021
Article Synopsis
- The study focuses on understanding the characteristics of healed plaques (HPs) in patients with coronary artery lesions using advanced imaging techniques like optical coherence tomography (OCT) and coronary angioscopy (CAS).
- Out of 33 patients, HPs were identified in 52.8% of lesions, which showed more severe conditions, such as worse blood flow and higher blockage than lesions without HPs.
- The presence of specific features like thin-cap fibroatheroma, macrophages, and red thrombus significantly predicted HPs and suggested that these healed lesions may still carry risks for future heart problems due to underlying inflammation.
Aim: A retrospective observational study to verify the impact of electrocardiograms (ECGs) following out-of-hospital cardiac arrest (OHCA) on mortality.
Methods: We retrospectively studied 101 OHCA patients who achieved a return of spontaneous circulation (ROSC) and survived for ≥3 h. Among them, 50 patients (66 ± 17 years; 22 male) were evaluated using 12-lead ECGs repeatedly and were included in the final analysis: immediately after ROSC (initial ECG) and after the initial evaluation in the emergency department (second ECG).
Previous studies have reported a circadian variation in the onset of ST-segment elevation myocardial infarction (STEMI). However, underlying mechanisms for the circadian variation have not been fully elucidated. We investigated the relationship between onset of STEMI and the underlying pathology using optical coherence tomography (OCT).
View Article and Find Full Text PDFBackground Seasonal variations in acute coronary syndromes (ACS) have been reported, with incidence and mortality peaking in the winter. However, the underlying pathophysiology for these variations remain speculative. Methods and Results Patients with ACS who underwent optical coherence tomography were recruited from 6 countries.
View Article and Find Full Text PDFBackground And Aims: Elevated pentraxin-3 (PTX3) values are associated with vulnerable plaque existence and poor outcomes in acute coronary syndrome patients. The clinical significance of PTX3 values in stable angina pectoris (SAP) patients is, however, undetermined. We investigated the relationship of systemic PTX3 values and coronary plaque components and post-percutaneous coronary intervention (PCI) outcomes in SAP patients.
View Article and Find Full Text PDFObjective: This study aimed to investigate the prevalence and prognostic significance of atherosclerotic aortic plaques (AAPs) or specific AAP types detected by nonobstructive angioscopy (NOA) in patients who underwent percutaneous coronary intervention (PCI).
Background: Although recent studies have reported the presence of various patterns of AAPs, identified by NOA, the clinical significance of the presence of AAPs remains elusive.
Methods: In this retrospective, multicenter cohort study, a total of 167 patients who underwent PCI and intra-aortic scans with NOA were studied.