Publications by authors named "Toshiaki Otsuka"
Background And Aims: Hypertensive emergencies, characterized by elevated blood pressure (BP) and multiple organ damage, have poor prognosis. Patients occasionally show gradual improvement in renal function with appropriate antihypertensive treatment despite renal impairment. However, reports analyzing factors predicting prognosis in patients with hypertensive emergencies and severe renal impairment are limited.
View Article and Find Full Text PDFBackground: A small mitral valve area (MVA) is one of the challenging anatomies for transcatheter edge-to-edge repair (TEER) for mitral regurgitation, but the relationship between baseline MVA and clinical outcomes remains unknown. This study aimed to evaluate the association of baseline MVA with procedural and clinical outcomes in patients undergoing TEER with MitraClip from the OCEAN-Mitral registry (Optimized Catheter Valvular Intervention-Mitral).
Methods: A total of 1768 patients undergoing TEER were divided into 3 groups according to baseline MVA: group 1: <4.
Article Synopsis
- - The study compares the hemodynamic performance and clinical outcomes of self-expandable valves (SEV) and balloon-expandable valves (BEV) in patients with small aortic annulus (SAA) undergoing transcatheter aortic valve replacement (TAVR).
- - Results showed that SEV offered better hemodynamics, with a higher rate of severe prosthesis-patient mismatch and a greater mean pressure gradient in patients receiving BEV, while BEV had lower incidences of paravalvular leakage and new permanent pacemaker implantation.
- - Overall, both valve types had similar device success rates, indicating that SEV is superior in hemodynamic outcomes but BEV has advantages in reducing certain complications. *
Article Synopsis
- This study explores the relationship between handgrip strength and all-cause mortality in patients undergoing transcatheter edge-to-edge repair (TEER) for heart issues, suggesting that weaker grip strength could indicate a higher risk of death post-procedure.
- It includes data from the OCEAN-Mitral Registry, which analyzed handgrip tests of 2077 patients before TEER, with follow-ups showing varied changes in strength based on the success of the procedure.
- The findings suggest that improving mitral regurgitation (MR) post-TEER can positively impact frailty and resilience, making this research a significant insight into patient outcomes in heart-related treatments.
Article Synopsis
- This study examined how left ventricular ejection fraction (LVEF) changes after a specific heart valve repair procedure called transcatheter edge-to-edge valve repair (TEER) in patients with mitral regurgitation (MR).
- Findings revealed that 32% of patients experienced worsened LVEF after the procedure, linked to increased end-systolic volumes in the heart and certain predictors like higher LVEF and levels of B-type natriuretic peptide.
- Despite the LVEF worsening, long-term outcomes (like death or hospitalization for heart failure) were similar for both patients with worsened and preserved LVEF, indicating that LVEF change might not significantly impact overall health results post-TEER
Background: The Direct Oral Anticoagulant (DOAC) Score can predict bleeding risk in patients with atrial fibrillation taking DOACs; however, it lacks external validation. Therefore, this study aimed to assess the association between the DOAC Score and bleeding events in patients with atrial fibrillation who underwent transcatheter aortic valve replacement.
Methods And Results: This retrospective multicenter cohort study included patients with atrial fibrillation who underwent transcatheter aortic valve replacement, as registered in a Japanese multicenter registry.
Aims: Few studies have investigated the impact of sleep duration at night and daytime napping on mortality from aortic disease. In this study, we examined the associations of sleep duration at night with daytime napping and mortality from aortic disease.
Methods: We followed 67,269 participants (26,826 men and 40,443 women, aged 40-79 years) who were not night shift workers and had no history of stroke, heart disease, or cancer.
Background: The Clinical Frailty Scale (CFS) is a useful frailty marker for predicting clinical outcomes in patients undergoing invasive therapy. However, the clinical impact of CFS after transcatheter edge-to-edge repair in patients with mitral regurgitation (MR) remains unclear. This study aimed to elucidate the association between the baseline frail status defined by the CFS and clinical outcomes with or without postprocedural MR ≥2+ (post-MR ≥2+) after transcatheter edge-to-edge repair.
View Article and Find Full Text PDFArticle Synopsis
- East Asians typically have smaller aortic valve complexes compared to Western populations, and there’s limited data on TAVI outcomes in Asian patients with large annuli.
- This study analyzes TAVI results in Asian patients, comparing outcomes between balloon-expandable valves (BEVs) and self-expandable valves (SEVs) by examining data from the OCEAN-TAVI registry.
- Findings show no significant differences in 3-year all-cause mortality, heart failure rehospitalization rates, or valve function after 2 years between BEV and SEV groups, although SEVs had higher rates of paravalvular leakage and pacemaker implantation.
Article Synopsis
- This study reviewed the effectiveness and safety of mucosal incision-assisted biopsy (MIAB) for diagnosing gastric subepithelial tumors (SETs).
- The analysis included 11 studies with a total of 339 cases, showing a high diagnostic rate of 87.8% and a very low adverse event rate of 0.2%.
- The use of acid secretion inhibitors proved effective in reducing postoperative bleeding, while the benefits of local injection to prevent complications were not clearly established.
Article Synopsis
- * Out of 1474 patients analyzed, 18.4% received higher doses of beta-blockers one month post-surgery, showing a significant association with lower risks of all-cause and cardiovascular mortality.
- * The findings suggest that adjusting beta-blocker therapy after M-TEER can lead to improved outcomes, particularly for patients with a low left ventricular ejection fraction (LVEF) of 40% or less.
Article Synopsis
- - The study investigates how mismatched residual mitral regurgitation (MR) and left atrial pressure (LAP) after a specific heart procedure (TEER) can negatively impact clinical outcomes in patients with severe MR and heart failure.
- - Researchers categorized 1,477 patients into three groups based on their MR and LAP levels, finding that those with mismatched or poor conditions faced higher risks of death and heart failure hospitalization compared to those in an optimal state.
- - Six key factors were identified as predictors of hemodynamic mismatch after TEER, including body mass index and pre-procedural pressures, suggesting that monitoring these could help improve patient outcomes.
Aims: Mitral transcatheter edge-to-edge repair (M-TEER) is a valid treatment option for severe mitral regurgitation (MR), necessitating accurate risk stratification of M-TEER candidates for effective patient selection, optimal periprocedural care and improved long-term outcomes. The body mass index (BMI) is a simple and practical prognostic index, and the obesity paradox has been widely reported.
Methods And Results: Between April 2018 and June 2021, 2149 patients undergoing M-TEER were registered in the prospective multicentre registry and classified into three groups: underweight (BMI < 18.
Background: Smoking elevates blood pressure (BP) whereas smoking cessation increases body weight (BW), which predisposes new quitters to the development of hypertension. This study aimed to investigate the effect of smoking cessation and subsequent BW change on the odds of developing hypertension.
Methods: A total of 10,354 Japanese male workers (mean age, 38.
Article Synopsis
- The study aimed to assess the effectiveness of endoscopic hand suturing (EHS) in reducing postoperative bleeding after gastric endoscopic submucosal dissection (ESD) in patients on antithrombotic agents (ATAs).
- It involved a phase II multicenter study with 49 enrolled patients, 43 of whom were evaluated; the postoperative bleeding rate was found to be 7%, significantly lower than the expected 10% rate.
- The success rate of EHS was 100%, with minimal complications, suggesting that EHS is a promising method to mitigate bleeding risks in these high-risk patients.
Aim: Increased arterial stiffness impairs the functional and structural properties of arteries, which in turn elevates blood pressure (BP). The aim of this study was to test whether indices obtained from the second derivative of the finger photoplethysmogram (SDPTG), a marker of arterial stiffness, predict future development of hypertension in middle-aged men.
Methods: The SDPTG was measured in 902 men without hypertension (mean age 44±6 years) at an annual medical checkup.
Article Synopsis
- The study investigates the link between acute aortic dissection (AAD) hospitalizations and ambient temperature, highlighting its public health importance due to AAD being a life-threatening condition.
- Using data from a nationwide registry, researchers analyzed hospitalizations from 2012 to 2020 and employed statistical models to assess temperature's impact on AAD cases.
- Findings indicate that lower ambient temperatures significantly increase AAD-related hospitalizations, especially among older individuals, women, those with low body mass index, and during winter months.
Article Synopsis
- - The study explores outcomes of patients with mitral stenosis (MS) who underwent transcatheter aortic valve implantation (TAVI) alongside those with aortic stenosis (AS) but no MS, focusing on factors like mitral annulus calcification (MAC), transmitral gradient (TMG), and mitral valve area (MVA).
- - Findings showed that patients with MS were generally older, predominantly female, and had a higher surgical risk score compared to those without MS; however, their 30-day mortality rates were similar.
- - Over a median follow-up of 2.1 years, patients with MS had a significantly higher rate of adverse events than the control group, indicating that MS adversely affects clinical outcomes post
Article Synopsis
- - Heart failure can reduce blood flow to the brain, potentially affecting recovery after mechanical thrombectomy (MT) in stroke patients, and this study examined the relationship between brain natriuretic peptide (BNP) levels and recovery outcomes.
- - Data from 169 stroke patients showed that those with favorable outcomes (score of 0-2 on the modified Rankin scale at 3 months) had lower median BNP levels compared to those with unfavorable outcomes, suggesting that higher BNP levels are linked to poorer recovery.
- - The analysis indicated that patients with BNP levels above 186 pg/mL had a significantly lower rate of favorable outcomes, even when considering other factors like atrial fibrillation, reinforcing the idea that high BNP concentration correlates with
Article Synopsis
- The Navitor intra-annular self-expanding heart valve (IA-SEV) is a new transcatheter heart valve introduced in Japan in April 2022, aimed at improving patient outcomes compared to the previous Portico valve.
- A study assessed the patient-prosthesis mismatch (PPM) and other outcomes in 463 Asian patients, finding that 91.7% of patients had no PPM, with a low in-hospital mortality rate of 1.9%.
- Overall, the IA-SEV demonstrated excellent hemodynamic results and reduced paravalvular leakage, making it particularly beneficial for Asian patients who often have smaller annulus sizes.
Article Synopsis
- The study analyzed 1,402 hospitalized patients with acute heart failure (AHF) to evaluate the fibrinogen-to-albumin ratio (FAR) and categorized patients into three groups based on their FAR values.
- It found that high FAR was linked to inflammation, diabetes mellitus, and ischemic heart disease, and these patients had a significantly poorer prognosis for all-cause mortality over 730 days compared to those with medium or low FAR.
- In contrast, in patients with low albumin levels, low FAR was an independent predictor of multiple adverse outcomes, including 730-day mortality and heart failure events.
Article Synopsis
- Enteral nutrition is crucial for stroke patients who struggle with eating, but traditional feeding methods are time-consuming and can disrupt care.
- The Rapid EN trial aims to compare the safety of quickly administering enteral nutrition (100 mL in 5 minutes) versus the conventional method (100 mL in 30 minutes) in acute stroke patients.
- The study will track complications like vomiting and pneumonia within 7 days, assessing if the faster method is equally safe while also looking at overall treatment times and clinical outcomes.
Article Synopsis
- - The study investigates sex differences in cardiovascular disease (CVD) among Japanese patients, focusing on conditions like acute coronary syndrome (ACS), acute heart failure (AHF), and acute aortic disease, amid a growing prevalence due to an aging population.
- - Analyzing data from over 1.3 million patients, findings revealed that ACS patients were generally younger and had the lowest female representation, while AHF patients were older and had a higher proportion of females; acute aortic disease showed the highest in-hospital mortality.
- - The results emphasize the need for sex-specific approaches in understanding and managing CVD in Japan, as significant disparities in hospitalization and mortality rates were observed based on sex.
Article Synopsis
- * The analysis found no significant difference in all-cause death or heart failure rehospitalization rates between patients with small (23-mm) and larger SEVs (26 or 29-mm) during a median follow-up of 511 days.
- * The results suggest that small SEVs provide midterm clinical outcomes similar to larger SEVs, even in cases of postprocedural prosthesis-patient mismatch.