Publications by authors named "Wen-Chung Yu"
Background: Supranormal left ventricular ejection fraction (LVEF) confers a paradoxically higher mortality risk; however, whether intrinsic structural changes of left ventricle (LV) play an important role remain unclear.
Objectives: The authors sought to investigate the prognostic implication of supranormal LVEF and its interaction with LV concentric remodeling.
Methods: Consecutive participants undergoing echocardiography in a tertiary medical center with LVEF >60% were included.
Transthoracic echocardiography plays a crucial role in clinical diagnosis and is increasingly being used around the world. Comprehensive echocardiographic examinations require accurate measurements and the operators to have excellent technical skills. Despite the availability of several published echocardiographic guidelines, the absence of recommended operational manuals in daily practice has resulted in significant variation in the content of echocardiography reports across different medical institutions.
View Article and Find Full Text PDFThis 2025 updated consensus outlines the diagnostic strategy for transthyretin amyloid cardiomyopathy (ATTR-CM). Given that ATTR-CM is a significant contributor to heart failure, this article emphasizes the importance of making an early and precise diagnosis, particularly as new therapeutic options become available. Highlighting the critical importance of an early and accurate diagnosis, particularly in light of emerging therapeutic modalities, this consensus underscores the central role of Tc-pyrophosphate (PYP) scintigraphy as a non-invasive diagnostic tool.
View Article and Find Full Text PDFTransthyretin (TTR), a homo-tetrameric protein encoded by the TTR gene, can lead to amyloid diseases when destabilized by mutations. The TTR-Ala97Ser (A97S) mutation is the predominant pathogenic variant found in Han-Taiwanese patients and is associated with late-onset familial amyloid polyneuropathy (FAP), which presents a rapid progression of symptoms affecting peripheral nerves and the heart. In this study, we combined nuclear magnetic resonance (NMR) spectroscopy and X-ray crystallography to investigate how the A97S mutation impacts the structure and dynamics of TTR.
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- RNA interference (RNAi) therapeutics, specifically patisiran and vutrisiran, were studied for their effects on transthyretin amyloid cardiomyopathy (ATTR-CA) by analyzing SPECT/CT imaging outcomes.
- Eight patients with hereditary ATTR-CA were monitored, with one group starting RNAi treatment alongside their first imaging, and another group being on treatment prior to imaging.
- Findings revealed a significant decrease in a volumetric heart/lung ratio in patients receiving RNAi therapies, indicating potential benefits in managing ATTR-CA symptoms.
Background: Heart failure (HF) with improved ejection fraction (HFimpEF) is a recently identified phenotype of HF, which had better cardiovascular outcomes compared with persistent HF with reduced ejection fraction (HFrEF). The present study aimed to investigate the predictive value of tissue inhibitor of metalloproteinase (TIMP)-1 and matrix metalloproteinases-9 (MMP-9) in the recovery of left ventricular ejection fraction (LVEF).
Methods: Subjects who presented with acute decompensated HF and reduced LVEF of ≤40% were eligible for this study.
Article Synopsis
- Fabry disease (FD) is an X-linked lysosomal storage disorder caused by mutations in the α-galactosidase A gene, leading to harmful buildup of glycosphingolipids in various tissues and classified into classic and late-onset phenotypes.
- Classic phenotype shows severely reduced enzyme activity, resulting in a progressive disease with multi-organ issues, while late-onset often presents with milder symptoms and mainly affects the heart due to some remaining enzyme activity.
- Early diagnosis through enzyme testing, imaging, and genotyping is crucial for effective treatment, which includes enzyme replacement therapy and new pharmacological options to prevent irreversible damage and optimize patient care based on genetic and gender considerations.
It remains unclear whether non-vitamin K antagonist oral anticoagulants (NOACs) are more effective and safer than warfarin in low-weight patients with atrial fibrillation (AF). Here, we retrospectively compared the effectiveness and safety of NOACs with those of warfarin in low-weight patients with AF. We extracted the July 2011-September 2022 data of patients with AF treated with a NOAC (dabigatran, rivaroxaban, apixaban, or edoxaban) or warfarin at a tertiary hospital.
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- Echocardiography is widely used to evaluate hydration and cardiac function in kidney failure patients, and this study explored the prevalence and significance of echocardiographic abnormalities in this population.* -
- Out of 857 kidney failure patients, 77% showed echocardiographic abnormalities, with left ventricular hypertrophy being most common; however, key predictors of adverse cardiovascular events and mortality were related to left ventricular function and volume rather than these abnormalities.* -
- The study's findings suggest that specific heart functions, especially left ventricular issues, are crucial for predicting outcomes in kidney failure patients, which can guide better patient management strategies.*
Article Synopsis
- Differentiating left ventricular hypertrophy (LVH) from conditions like hypertrophic cardiomyopathy (HCM) and Fabry disease is complex and often requires input from various specialists, which leads to inconsistent diagnoses.
- *A new AI-based tool called the MRI short-axis view left ventricular hypertrophy classifier (MSLVHC) has been developed to accurately distinguish HCM from Fabry disease using MRI cine images and has shown high accuracy and strong performance metrics.
- *The model not only demonstrated reliability in tests at two hospitals but also holds potential to enhance the diagnostic process for specialists dealing with LVH-related conditions.
Article Synopsis
- * It categorizes LVH severity based on left ventricular mass index (LVMI) and assesses left ventricular function using global longitudinal strain (GLS).
- * Findings show that the severity of LVH and impaired GLS are associated with higher rates of major adverse cardiovascular events (MACE) over five years, suggesting that these factors can serve as important risk indicators for patients with Fabry disease.
Background: While cardiovascular complications are the most common cause of mortality in Fabry disease, the relationship between globotriaosylceramide (GL-3) accumulation, the hallmark of Fabry cardiomyopathy, and cardiac hypertrophy has not been fully elucidated.
Methods: We developed unbiased stereology protocols to quantify the ultrastrcture of Fabry cardiomyopathy. Endomyocardial biopsies from 10 adult male enzyme replacement therapy naïve Fabry patients with IVS4 + 919G>A GLA mutation were studied.
Introduction: Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) have been linked to clinical outcomes in patients with coronary artery disease (CAD). However, the prognostic value of TIMP-1 in patients with CAD who underwent coronary artery bypass grafting (CABG) has not been elucidated. We aimed to investigate the correlations of TIMP-1 with high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in the long-term prognosis of consecutive patients who underwent CABG.
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- Constrictive pericarditis (CP) is a rare cause of heart failure that can be treated if diagnosed early, but current diagnosis methods are challenging for doctors.
- Researchers aimed to use deep learning with echocardiography images to differentiate CP from restrictive cardiomyopathy, specifically cardiac amyloidosis (CA).
- The study analyzed data from 381 patients, achieving a high performance (0.97 area under the curve) in distinguishing CP from CA, and demonstrated that their AI model could improve the diagnosis process for CP.
Article Synopsis
- Transthyretin amyloidosis (ATTR) leads to amyloid deposits in the heart, resulting in progressive cardiomyopathy, and patisiran has been developed to reduce the production of transthyretin in the liver.
- In a phase 3 trial, 360 patients with hereditary or wild-type ATTR cardiac amyloidosis received either patisiran or a placebo for 12 months, with various health metrics being assessed.
- Results showed that patients receiving patisiran experienced less decline in the 6-minute walk test and improved health scores compared to the placebo group, although benefits for some secondary outcomes were not significant and adverse reactions were noted.
Symptom-limited exercise capacity is associated with long-term survival.
Medicine (Baltimore)
September 2023
The prognostic value of exercise capacity has been demonstrated in subjects with established cardiovascular diseases. We aim to evaluate the independence of exercise capacity measured by treadmill exercise test (TET) in predicting long-term outcomes among various comorbidities. This study was conducted from January 2003 to December 2012 in a tertiary medical center in Taiwan.
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- Surgery helps patients with severe primary mitral regurgitation (PMR) live longer, but it doesn't seem to help those with severe secondary mitral regurgitation (SMR) as much.
- The study looked at over 1,100 heart failure patients from 2002 to 2012, comparing those with PMR and SMR.
- Results showed more PMR patients had surgery and benefited from it, while SMR patients often had other health issues that affected their survival.
Background: Using technetium (Tc)-labelled pyrophosphate (PYP) cardiac scintigraphy, a non-invasive diagnosis of transthyretin amyloid (ATTR) cardiomyopathy can be made without histopathological confirmation. In patients suspected of ATTR cardiomyopathy, however, atypical presentations may necessitate further investigation.
Case Summary: A 30-year-old man with hypertension and end-stage renal disease on peritoneal dialysis presented with progressive exertional dyspnoea.
Article Synopsis
- - The study investigates rare cases of systemic hyper-inflammation with multi-organ involvement observed in two patients after receiving the ChAdOx1 nCoV-19 vaccine, while comparing their immune responses to healthy vaccinated controls.
- - Blood samples were analyzed for biochemical parameters and immune profiles, revealing significant elevations in various cytokine levels in the patients, indicating a strong inflammatory response.
- - The findings suggest that systemic inflammation can be a rare adverse effect of the ChAdOx1 nCoV-19 vaccine and identify specific immune markers that might play a role in the inflammation process.
Article Synopsis
- Cardiac amyloidosis is a type of systemic amyloidosis where abnormal amyloid fibrils accumulate in heart tissue, leading to heart failure due to restrictive cardiomyopathy and conduction problems.
- The condition is more common than previously thought, especially in certain populations, but is often diagnosed late, indicating a need for better awareness and collaboration among healthcare professionals.
- The Taiwan Society of Cardiology has created an "Expert Consensus" to enhance the diagnosis and treatment of cardiac amyloidosis, introducing helpful tools and algorithms to aid in early detection and care for patients, including acronyms for diagnosing transthyretin amyloid cardiomyopathy.
Background: Spirometric abnormalities have been related to incident heart failure in general population, who generally have preserved left ventricular ejection fraction (LVEF). We aimed to investigate the association between spirometric indices, cardiac functions and clinical outcomes.
Methods: Subjects presenting with exertional dyspnoea and received spirometry and echocardiography were eligible for this study.
Background A previously underrecognized phenotype of left ventricular apical aneurysm (LVAA) has been increasingly identified in Fabry disease. This study explored LVAA's clinical prevalence and its prognostic implications over a long-term follow-up. Methods and Results We retrospectively analyzed 268 consecutive patients with Fabry disease at a tertiary medical center.
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