Publications by authors named "Tetsuji Shinohara"

Article Synopsis
  • Catheter ablation for atrial fibrillation in patients with heart failure and preserved ejection fraction (HFpEF) may reduce hospitalizations but long-term outcomes are still unclear.
  • A study with 190 patients found no significant difference in deaths or hospitalizations between those with and without HF, but more HFpEF patients experienced subclinical heart failure post-procedure.
  • High levels of NT-proBNP and low voltage areas in heart scans were identified as strong predictors for developing subclinical heart failure in HFpEF patients after ablation.
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Endothelial dysfunction may trigger coronary spastic angina (CSA). However, the risk factors for CSA in young patients remain unclear. This study aimed to investigate the age-dependent role of serum uric acid levels in patients with CSA.

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Article Synopsis
  • The study evaluates the effectiveness of the Predicting Arrhythmic evenT (PAT) score in predicting future ventricular fibrillation (VF) events in patients with Brugada syndrome (BrS), particularly those without prior VF.
  • Researchers analyzed 413 patients from 59 hospitals in Japan over a follow-up period of about 107 months, finding that while 13.1% experienced VF events, the PAT score didn't effectively differentiate risk in those without a history of VF.
  • Overall, the study concluded that the PAT score is not a reliable tool for predicting future VF events in BrS patients without previous VF, indicating a need for further validation of risk stratification models.
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Background: The prevalence of transthyretin amyloid cardiomyopathy (ATTR-CM) in atrial fibrillation (AF) patients remains unclear. We explored the efficacy of computed tomography-based myocardial extracellular volume (CT-ECV) combined with red flags for the early screening of concealed ATTR-CM in AF patients undergoing catheter ablation.

Methods and results: Patients referred for AF ablation at Oita University Hospital were prescreened using the red-flag signs defined by echocardiographic or electrocardiographic findings, medical history, symptoms, and blood biochemical findings.

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Epicardial adipose tissue (EAT) have been shown to be associated with several heart disease, including coronary artery disease (CAD), atrial fibrillation (AF), and heart failure (HF). It is reported that the quality of EAT, represented by fat attenuation determined using computed tomography (CT) imaging, can detect the histologically-assessed remodeled EAT. We tested the hypothesis that quality of EAT would predict major adverse cerebral and cardiovascular events (MACCE) following transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis (AS).

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Background During the early phase of the coronavirus disease 2019 (COVID-19) pandemic, a global reduction in hospitalizations for acute myocardial infarction (AMI) was observed. Generally, patients experienced increased severity of AMI with delays in time from symptom onset to treatment during the pandemic. However, the impact of the COVID-19 pandemic on in-hospital mortality among patients with AMI remains unclear.

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Introduction: Most patients with Brugada syndrome (BrS) are first diagnosed in their 40s, with sudden cardiac death (SCD) often occurring in their 50s. Ventricular fibrillation (VF) may occur in some patients with BrS despite having been asymptomatic for a long period. This study aimed to assess the incidence and risk factors for late life-threatening arrhythmias in patients with BrS.

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Background: Typical left bundle branch block (LBBB) shows 2 peaks of the R wave, which reflect activation reaching the interventricular septum (R) and posterolateral wall (R') sequentially.

Objective: The purpose of this study was to investigate the relationship among R-R' interval (RR'), mechanical dyssynchrony, extent of viable myocardium, and long-term outcomes in cardiac resynchronization therapy (CRT) candidates.

Methods: The study enrolled 49 patients (34 men; mean age: 69 ± 11 years) with LBBB who received CRT.

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Background: We have reported that a prehospital 12-lead electrocardiography system (P-ECG) contributed to transport of suspected acute coronary syndrome (ACS) patients to appropriate institutes and in this study, we compared its usefulness between urban and rural areas, and between weekday daytime and weekday nighttime/holiday.

Methods and results: Consecutive STEMI patients who underwent successful primary percutaneous coronary intervention after using P-ECG were assigned to the P-ECG group (n=123; 29 female, 70±13 years), and comparable STEMI patients without using P-ECG were assigned to the conventional group (n=117; 33 females, mean age 70±13 years). There was no significant difference in door-to-reperfusion times between the rural and urban cases (70±32 vs.

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Article Synopsis
  • n-3 polyunsaturated fatty acids (PUFAs), like EPA and DHA, are linked to reduced risk of ischemic heart disease, yet their relationship with coronary spastic angina (CSA) is unclear.
  • A study with 406 patients found that younger individuals with CSA had significantly higher serum levels of EPA and DHA compared to those without CSA, while this trend was not observed in older patients.
  • The findings suggest that elevated levels of EPA and DHA may play a role in the occurrence of CSA among younger patients, but not in the elderly.
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  • Recent research indicates that fat accumulation in the interatrial septum (IAS) may play a significant role in causing atrial fibrillation (AF), and this study explores how transesophageal echocardiography (TEE) can effectively assess IAS fat in AF patients.
  • The imaging results showed greater IAS fat volume relative to epicardial fat in patients with persistent AF compared to those with paroxysmal AF, suggesting a link between IAS adiposity and AF severity.
  • Histological analysis from autopsy samples revealed thicker IAS in AF patients and highlighted changes like "myocardial splitting" due to IAS fat infiltration, which may contribute to atrial cardiomyopathy associated with AF.
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Article Synopsis
  • * Researchers analyzed 164 AF patients who underwent ablation, finding that those with longer P-LAA (a measure of IACT) were older, had more severe AF cases, and presented a higher likelihood of recurrence of AF or atrial tachycardia post-ablation.
  • * The findings indicate that longer IACT (P-LAA ≥ 84 ms) and the presence of LVA are significant predictors of AF recurrence, highlighting the importance of these metrics
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Background: Wolff-Parkinson-White syndrome is characterized by a short PR interval (delta-wave), long QRS complex, and the appearance of paroxysmal supraventricular tachycardia. Patients with Wolff-Parkinson-White syndrome usually have one accessory pathway, whereas cases with multiple accessory pathways are rare. Persistent left superior vena cava is a vascular anomaly in which the vein drains into the right atrium through the coronary sinus at the junction of the left internal jugular and subclavian veins due to abnormal development of the left cardinal vein.

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Background: Patients with early repolarization syndrome (ERS) and Brugada syndrome (BruS) have comparable clinical symptoms. In both conditions, ventricular fibrillation (VF) is experienced often near midnight or in the early morning hours when the parasympathetic tone is augmented. However, differences between ERS and BruS regarding the risk of VF occurrence have recently been reported.

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Background: The outcome of catheter ablation could probably differ among patients with atrial fibrillation (AF), depending on age and AF type. We aimed to investigate the difference in predictors of outcome after catheter ablation for AF among the patient categories divided by age and AF type.

Methods And Results: A total of 396 patients with AF (mean age 65.

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Background: Brugada syndrome (BrS), which is characterized by J-point elevation in right precordial leads of a 12-lead electrocardiogram, is associated with the occurrence of ventricular fibrillation (VF). However, risk stratification of VF in patients with BrS remains challenging.

Objective: The aim of this study was to identify a risk predictor of VF in patients with BrS using pharmacological tests.

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A 19-year-old man with pectus excavatum developed symptomatic persistent atrial fibrillation (AF). He had no remarkable medical history or comorbidities and had not exercised intensely during childhood. Electrical cardioversion and pre-treatment with amiodarone for two months failed to maintain sinus rhythm.

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Aim: This study aimed to determine possible associations between sarcopenia and poor cardiovascular outcomes in patients with chronic heart failure after cardiac resynchronization therapy.

Methods: This retrospective study evaluated 120 patients who underwent cardiac resynchronization therapy between March 2004 and June 2018. In total, 58 patients who underwent computed tomography within 30 days of cardiac resynchronization therapy implantation were eligible for inclusion, and their data were analyzed (25 women; 33 men; mean age 71.

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Background: Arrhythmogenic right-ventricular cardiomyopathy (ARVC) is a hereditary cardiomyopathy characterized by fibro-fat replacement of the right-ventricular myocardium. There are many factors associated with poor prognosis in patients with ARVC. Among these factors, intensive physical exertion is considered an important risk factor for sudden cardiac death.

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