Publications by authors named "Tomoharu Dohi"
Article Synopsis
- In a study analyzing treatments for persistent atrial fibrillation (AF), researchers compared extensive ablation techniques (including pulmonary vein isolation and additional methods) with just pulmonary vein isolation (PVI) in young (<65 years) and elderly (≥65 years) patients.
- They found that while both methods were equally effective in younger patients, extensive ablation significantly reduced AF recurrence in elderly patients.
- The study concluded that extensive ablation is a more effective treatment for elderly patients with persistent AF, without any serious procedural complications reported.
Background: It has not been fully elucidated which patients with persistent atrial fibrillation (PerAF) should undergo substrate ablation plus pulmonary vein isolation (PVI). This study aimed to identify PerAF patients who required substrate ablation using intraprocedural assessment of the baseline rhythm and the origin of atrial fibrillation (AF) triggers.
Methods and results: This was a post hoc subanalysis using extended data of the EARNEST-PVI trial, a prospective multicenter randomized trial comparing PVI-alone and PVI-plus (i.
Background: Based on the results of a clinical trial in Japan, transcatheter aortic valve replacement (TAVR) for hemodialysis (HD) patients gained approval; however, mid-term TAVR outcomes and transcatheter aortic valve (TAV) durability in HD patients remain unexplored.
Methods and results: We analyzed background, procedural, in-hospital outcome, and follow-up data for 101 HD patients and 494 non-HD patients who underwent TAVR using balloon-expandable valves (SAPIEN XT or SAPIEN 3) retrieved from Osaka University Hospital TAVR database. Periprocedural mortality and TAVR-related complications were comparable between HD and non-HD patients.
Article Synopsis
- The study focused on creating a tool to assess the risks of bleeding and thrombosis in patients with myocardial infarction undergoing percutaneous coronary intervention (PCI).
- It involved analyzing data from two patient cohorts: one for developing the tool (4554 patients) and another for validating it (2215 patients).
- The resulting model effectively stratified patients based on their risk probabilities, aiding in tailored treatment decisions for both STEMI and non-STEMI cases.
Article Synopsis
- The study investigates how the duration of atrial fibrillation (AF) affects the success of catheter ablation in patients with long-standing AF (LsAF).
- It found that patients with LsAF lasting 1-2.4 years have similar outcomes to those with persistent AF (PerAF), but those with LsAF over 2.4 years face a higher risk of arrhythmia recurrence.
- Additionally, patients with LsAF over 2.4 years might benefit more from a combined ablation strategy (PVI-plus) than from a standard approach (PVI-alone).
Article Synopsis
- A study aimed to find patients with persistent atrial fibrillation (AF) who would benefit from extensive catheter ablation, using a machine learning method called uplift modeling.
- The research identified the best model as adaptive boosting, which indicated that an uplift score of 0.0124 could effectively determine who would benefit from the more extensive procedure.
- Results showed that patients with an uplift score of 0.0124 or higher had a significantly lower recurrence of AF with the extensive ablation (PVI-plus) compared to those receiving only the standard procedure (PVI-alone).
Article Synopsis
- The study investigates the impact of β-blocker medications on the prognosis of patients with heart failure who have preserved ejection fraction (HFpEF), specifically focusing on the level of frailty as measured by the Clinical Frailty Scale (CFS).
- Among the 1159 patients analyzed, those with higher frailty (CFS ≥ 4) experienced worse outcomes, including higher rates of death and heart failure readmission when using β-blockers, while those with lower frailty (CFS ≤ 3) did not show significant negative effects.
- The findings suggest that careful consideration is necessary when prescribing β-blockers to frail HFpEF patients, as the risks may outweigh the benefits in this group.
Article Synopsis
- The study focuses on heart failure with preserved ejection fraction (HFpEF) and aims to understand the differences in biomarkers among its various phenotypes to shed light on their underlying mechanisms.* -
- It utilizes data from the PURSUIT-HFpEF Study, which includes 1,231 patients, and identifies four distinct HFpEF phenotypes based on biomarker measurements from a subset of 212 patients.* -
- Results show that each phenotype has unique biomarker profiles, suggesting differential pathophysiological mechanisms, particularly the role of inflammation in conditions like hypertension and cardiac hypertrophy.*
Article Synopsis
- * Researchers analyzed data from 36 HFpEF patients who started ASV therapy from 2012 to 2017 and compared the number of heart failure hospitalizations before and after starting ASV at home.
- * Results showed a significant decrease in hospitalizations for heart failure after ASV was introduced, particularly among female patients, those with a lower body mass index, and those with significant tricuspid valve regurgitation.
Background An optimal strategy for left atrial ablation in addition to pulmonary vein isolation (PVI) in patients with persistent atrial fibrillation (AF) has not been determined. Methods and Results We conducted an extended follow-up of the multicenter randomized controlled EARNEST-PVI (Efficacy of Pulmonary Vein Isolation Alone in Patients With Persistent Atrial Fibrillation) trial, which compared 12-month rhythm outcomes in patients with persistent AF between patients randomized to a PVI-alone strategy (n=248) or PVI-plus strategy (n=248; PVI followed by left atrial additional ablation, including linear ablation or ablation targeting areas with complex fractionated electrograms). The present study extended the follow-up period to 3 years after enrollment.
View Article and Find Full Text PDFArticle Synopsis
- This study investigates the impact of major bleeding and recurrent myocardial infarction (ReMI) within 7 days of percutaneous coronary intervention (PCI) on the mortality of patients with acute myocardial infarction (AMI) in East Asia.
- A total of 6,769 eligible patients were followed for up to 5 years, revealing that major bleeding significantly increased the risk of death within 30 days and the first year post-PCI, while ReMI did not show a similar impact.
- The findings suggest that while major bleeding is linked to higher short-term mortality rates, it does not significantly affect long-term survival (1-5 years) in AMI patients.
Article Synopsis
- A systematic review and meta-analysis was conducted to compare the effects of P2Y12 inhibitor monotherapy versus conventional dual antiplatelet therapy (DAPT) in patients undergoing complex percutaneous coronary intervention (PCI).
- The analysis included six randomized trials with a total of 10,588 complex PCI patients and 25,618 non-complex PCI patients, focusing on the 1-year Net Adverse Clinical Event (NACE).
- Results showed that P2Y12 inhibitor monotherapy significantly lowered the risk of NACE in complex PCI patients, but only exhibited a trend towards lower risk in non-complex PCI patients.
There were few clinical studies on the relationship between sodium glucose cotransporter 2 inhibitors (SGLT2i) and hematopoiesis in patients with diabetes (DM) and heart failure (HF) with consideration of systemic volume status. A total of 226 DM patients with HF enrolled in the CANDLE trial, a multicenter, prospective, randomized open-label blinded-endpoint trial, were studied. Estimated plasma volume status (ePVS) was calculated based on a weight- and hematocrit-based formula.
View Article and Find Full Text PDFObjective: Our previously established machine learning-based clustering model classified heart failure with preserved ejection fraction (HFpEF) into four distinct phenotypes. Given the heterogeneous pathophysiology of HFpEF, specific medications may have favourable effects in specific phenotypes of HFpEF. We aimed to assess effectiveness of medications on clinical outcomes of the four phenotypes using a real-world HFpEF registry dataset.
View Article and Find Full Text PDFBackground: Little is known about intravascular imaging predictors of cardiac events after drug-eluting stent (DES) implantation in hemodialysis (HD) patients. We aimed to reveal the association between calcified nodules (CN) and target lesion failure (TLF) in HD patients after DES implantation.
Methods: We enrolled 114 HD patients who underwent DES implantation between October 2016 and October 2020.
Background: We recently reported that nearly half of patients with heart failure with preserved ejection fraction (HFpEF) did not show echocardiographic diastolic dysfunction (DD), but had normal diastolic function (ND) or indeterminate diastolic function (ID). However, the clinical course and outcomes of patients with HFpEF with ND or ID (ND/ID) remain unknown.
Methods: From the PURSUIT-HFpEF registry, we extracted 289 patients with HFpEF with ND/ID at discharge who had echocardiographic data at 1-year follow-up.
Background: Atrial fibrillation (AF) is common in heart failure with preserved ejection fraction (HFpEF).
Objectives: This study aimed to investigate the prognostic value of echocardiographic markers of congestion that can be applied to both AF and patients without AF with HFpEF.
Methods: We conducted a multicenter study of 505 patients with HFpEF admitted to hospitals for acute decompensated heart failure.
The impact of changes in nutritional status during hospitalization on prognosis in patients with heart failure with preserved ejection fraction (HFpEF) remains unknown. We examined the association between changes in the Geriatric Nutritional Risk Index (GNRI) and prognosis during hospitalization in patients with HFpEF stratified by nutritional status on admission. Nutritional status did and did not worsen in 348 and 349 of 697 patients with high GNRI on admission, and in 142 and 143 of 285 patients with low GNRI on admission, respectively.
View Article and Find Full Text PDFObjective: The association between serum uric acid levels and the risk of diabetes mellitus in women stratified by menopausal status is not well-established. Therefore, we investigated this association among a cohort of Japanese urban women.
Methods: We conducted a prospective cohort study on 3,304 women (1,252 premenopausal and 2,052 postmenopausal), aged 30 to 79 years, with no prior cardiovascular disease or diabetes mellitus, and enrolled from a general urban population.
Aim: We aimed to investigate the combined impact of liver enzymes and alcohol consumption on the diabetes risk.
Methods: Data on 5972 non-diabetic participants aged 30-79 years from the Suita study were analyzed. Diabetes incidence was surveyed every 2 years.
Background Modification of arrhythmogenic substrates with extensive ablation comprising linear and/or complex fractional atrial electrogram ablation in addition to pulmonary vein isolation (PVI-plus) can theoretically reduce the recurrence of atrial fibrillation. The DR-FLASH score (score based on diabetes mellitus, renal dysfunction, persistent form of atrial fibrillation, left atrialdiameter >45 mm, age >65 years, female sex, and hypertension) is reportedly useful for identifying patients with arrhythmogenic substrates. We hypothesized that, in patients with persistent atrial fibrillation, the DR-FLASH score can be used to classify patients into those who require PVI-plus and those for whom a PVI-only strategy is sufficient.
View Article and Find Full Text PDFTo investigate the difference in the prognostic impact of loop diuretics in patients with acute myocardial infarction (AMI) based on plasma volume status, a total of 3,364 survivors of AMI who were registered in the large database of the Osaka Acute Coronary Insufficiency Study (OACIS) were studied. Plasma volume status was assessed by the estimated plasma volume status (ePVS) that was calculated based on a weight- and hematocrit-based formula at discharge. The endpoint was a composite endpoint of all-cause death and rehospitalization due to heart failure for 5 years.
View Article and Find Full Text PDFFew data are available regarding the impact of atrial fibrillation (AF) at diagnosis and type of AF during the follow-up period on long-term outcomes in patients with heart failure with preserved ejection fraction (HFpEF). In all, 1,697 patients diagnosed as HFpEF between March 2010 and December 2017 were included in this study. At enrollment, 698 (41.
View Article and Find Full Text PDFAims: As part of efforts to identify candidates for patient education aimed at decreasing mortality from acute myocardial infarction, we investigated the prevalence of pre-infarction angina and its predictors among comorbidities in patients who were hospitalized with acute myocardial infarction (MI).
Methods: We conducted a prospective multicenter observational registry of MI patients from 1998 to 2014 ( = 12,093). The present study investigated the prevalence of pre-infarction angina and its predictors among comorbidities with a logistic regression model.