Publications by authors named "Toyama Kazuto"
Aims: Direct oral anticoagulants (DOACs) are used to treat venous thromboembolism (VTE). However, their impact on thrombus regression and the clinical outcomes after 2-week post-therapy computed tomography (CT) monitoring remains unexplored. This study aimed to elucidate the characteristics of patients with VTE treated with individual DOACs, assess the incidence of clinical events, and evaluate their impact on pulmonary artery thrombus regression.
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- The study examined the timing of electrical cardioversion (ECV) in patients with acute decompensated heart failure (ADHF) and atrial arrhythmias, comparing early ECV (within 8 days) to delayed ECV (9 days or more).
- Out of 73 patients, ECV successfully restored sinus rhythm in 85%, but there was no significant difference in short-term failure rates between early and delayed ECV groups.
- Early ECV was linked to a shorter hospital stay (14 vs. 17 days) and a notable increase in left ventricular ejection fraction (from 38% to 51%), suggesting better outcomes with earlier intervention.
Aims: Sodium-glucose co-transporter 2 (SGLT2) inhibitors have shown potential therapeutic benefits in heart failure (HF). However, data on their real-world usage and benefits in acute decompensated heart failure (ADHF) are limited.
Methods And Results: We conducted a post hoc analysis of real-world data from 1108 patients with ADHF admitted to Nihon University Itabashi Hospital (Tokyo, Japan) between 2018 and 2022.
Article Synopsis
- SGLT2 inhibitors like dapagliflozin may improve outcomes for patients with acute heart failure (AHF) when started early in treatment, but the optimal timing after hospital admission is unclear.
- A study assessed 118 AHF patients, dividing them into early (E) and late (L) groups based on when they started dapagliflozin; results showed no major differences in heart failure severity between the groups.
- Early initiation of dapagliflozin was linked to a significantly shorter hospital stay (16.5 days for E group vs. 22 days for L group), indicating it could be a crucial factor for reducing hospitalization time.
Aims: Acute decompensated heart failure (ADHF) presents with pulmonary congestion, which is caused by an increased pulmonary arterial wedge pressure (PAWP). PAWP is strongly associated with prognosis, but its quantitative evaluation is often difficult. Our prior work demonstrated that a deep learning approach based on chest radiographs can calculate estimated PAWP (ePAWP) in patients with cardiovascular disease.
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- The study investigates the prognostic value of the MELD-XI scoring system in patients with acute decompensated heart failure (ADHF), focusing on changes in scores during hospitalization.
- It categorized 536 patients based on their MELD-XI scores at admission and discharge into four groups: persistently normal, high-to-normal, normal-to-high, and persistently high, with the latter group facing the worst outcomes.
- The results showed that patients with persistently high MELD-XI scores had a significantly higher rate of death or rehospitalization compared to the other groups, indicating the score's usefulness in predicting patient outcomes.
Article Synopsis
- * Results showed that RV pacing with an optimal AV delay of 160 ms led to a higher stroke volume compared to intrinsic AV conduction, prompting the use of DDD mode pacing.
- * However, seven of the patients developed heart failure during the follow-up, particularly when their E/E' ratio was above 15, indicating the need to avoid RV pacing in patients with elevated E/E' ratios.
Liver stiffness (LS) assessed by ultrasound elastography reflects right-sided filling pressure and offers additional prognostic information in patients with acute decompensated heart failure (ADHF). However, the prognostic value of LS in heart failure (HF) with preserved ejection fraction (HFpEF) remains unclear. This study aimed to investigate the prognostic value of LS measured by two-dimensional shear wave elastography (2D-SWE) in patients with HFpEF.
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- * It involved 771 patients admitted for acute HF, comparing those on public assistance with those having other forms of insurance, and found the former group had higher rates of certain health issues but received similar quality care during hospitalization.
- * Despite comparable in-hospital outcomes, public assistance patients faced a significantly higher rate of cardiac events within one year post-discharge, indicating a need for enhanced follow-up care for these individuals.
Aims: Congestive splenomegaly is a classic sign of organ congestion in acute decompensated heart failure (ADHF). Shear wave elastography (SWE) allows the measurement of spleen stiffness (SS). We hypothesized that SS could quantify the severity of splenic congestion and predict adverse events in ADHF.
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