Publications by authors named "Yohei Ohno"
Decompensated hemolytic anemia after transcatheter aortic valve implantation (TAVI) requiring specific treatment is rarely encountered in actual clinical practice. Nevertheless, there have been several cases of clinically relevant hemolytic anemia following implantation of the recently launched SAPIEN 3 Ultra RESILIA (S3UR). This study aimed to elucidate the clinical features of hemolytic anemia following S3UR implantation.
View Article and Find Full Text PDFBackground: Transcatheter edge-to-edge repair (TEER) is used to treat patients with mitral regurgitation (MR). The Geriatric Nutritional Risk Index (GNRI) is a well-known nutritional marker that predicts mortality risk.
Objectives: The objectives of this study were to elucidate the clinical association between the degree of GNRI and different etiologies of MR and to clarify the patient samples for whom GNRI is more relevant to clinical outcomes following TEER.
Aims: Tricuspid regurgitation (TR) is often seen in patients with atrial functional mitral regurgitation (AFMR). The aim of this study was to investigate the characteristics, determinants, and prognostic impact of severe TR coexisting with AFMR.
Methods And Results: In 26 facilities in Japan, patients with significant AFMR defined with moderate or severe functional mitral regurgitation with dilated left atrium and preserved left ventricular function were enrolled.
Background: Renal impairment is associated with poor clinical outcomes in patients with cardiovascular diseases. Some studies have revealed the impact of renal impairment on the clinical outcomes of patients who underwent mitral valve transcatheter edge-to-edge repair (M-TEER). However, limited data are available regarding the impact of baseline renal impairment after M-TEER in Asian-Pacific patients with heart failure and severe mitral regurgitation.
View Article and Find Full Text PDFBackground: The 20-mm balloon-expandable transcatheter heart valve (THV) represents the smallest available option for transcatheter aortic valve replacement (TAVR). Its current underutilization stems from concerns regarding prosthesis-patient mismatch, durability, and potential adverse outcomes.
Objectives: The purpose of this study was to compare the long-term outcomes between the 20-mm balloon-expandable THVs and standard-size balloon-expandable THVs.
Aim: The mechanisms and clinical importance of acute reduction (ARD) in left ventricular (LV) function following transcatheter edge-to-edge repair (TEER) for mitral regurgitation (MR) remains unclear. This study aimed to non-invasively evaluate the cardio-mechanical parameters, including end-systolic elastance (Ees) and arterial elastance (Ea), to explore their association with ARD following mitral TEER.
Methods And Results: We performed a retrospective analysis of serial transthoracic echocardiography (TTE) studies before and after mitral TEER.
Background: Atrial functional mitral regurgitation (AFMR) arises from left atrial (LA) dilation, commonly associated with atrial fibrillation, and leads to progressive cardiac damage. This study evaluated the prognostic value of a novel echocardiographic cardiac damage classification system for patients with moderate or severe AFMR.
Methods: In a retrospective multicentre study, 1007 patients with AFMR were stratified into four groups based on echocardiographic findings: group 1, LA damage (dilation); group 2, left ventricular damage (reduced ejection fraction and/or dilation); group 3, right heart damage (tricuspid regurgitation and/or pulmonary hypertension); and group 4, combined left and right heart damage.
Background: Left atrial appendage closure (LAAC) has demonstrated favorable outcomes as an alternative to permanent anticoagulation in patients with nonvalvular atrial fibrillation (NVAF). In hemodialysis (HD) patients with NVAF, anticoagulation increases bleeding complications, with inconsistent benefits in stroke prevention.
Objectives: This study aimed to clarify the benefit of LAAC for HD patients.
Background And Aims: The association between periprocedural change in tricuspid regurgitation (TR) and outcomes in patients undergoing mitral transcatheter edge-to-edge repair (M-TEER) is unclear. This study aimed to examine the prognostic value of TR before and after M-TEER.
Methods: Patients in the OCEAN-Mitral registry were divided into four groups according to baseline and post-procedure echocardiographic assessments: no TR/no TR (no TR), no TR/significant TR (new-onset TR), significant TR/no TR (normalized TR), and significant TR/significant TR (residual TR) (all represents before/after M-TEER).
Background: Evidence regarding the incidence of prosthesis-patient mismatch (PPM) and long-term mortality after transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve stenosis (AS) is scarce.
Objectives: This study sought to assess the incidence and prognostic impact of PPM after TAVR for bicuspid AS compared with that for tricuspid AS.
Methods: In total, 7,393 patients who underwent TAVR were prospectively enrolled in the OCEAN-TAVI (Optimized Catheter Valvular Intervention Transcatheter Aortic Valve Implantation) registry, an ongoing Japanese, multicenter registry.
Article Synopsis
- HFpEF is commonly found in patients with moderate AFMR, significantly impacting clinical outcomes, leading to higher mortality and hospitalization rates.
- Patients with HFpEF-AFMR were generally older and faced more severe symptoms, including a higher prevalence of severe tricuspid regurgitation.
- Interventions, such as combined mitral and tricuspid valve procedures or rhythm control therapy, improved clinical outcomes compared to isolated treatments.
Background: 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.
Background: Research on the impact of angiographically detected residual trabeculation after left atrial appendage closure (LAAC) is limited.
Objectives: To investigate the incidence, characteristics, and clinical implications of angiographically detected residual trabeculation after LAAC using the WATCHMAN device.
Methods: We analyzed 1350 consecutive patients with atrial fibrillation undergoing LAAC using the WATCHMAN device from the OCEAN-LAAC registry, which is a prospective ongoing, multicenter Japanese registry.
Background: Prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) is of greater concern in Asians, considering their relatively smaller annular sizes compared with Westerners. However, the prognostic significance of PPM in Asian populations has not been demonstrated.
Objectives: This study aimed to elucidate the prognostic value of PPM after TAVR in Asian patients.
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
Qualitative and quantitative assessment of atrial functional mitral regurgitation: analysis from the REVEAL-AFMR registry.
Eur Heart J Cardiovasc Imaging
January 2025
Aims: The prevalence, characteristics, and prognosis of atrial functional mitral regurgitation (AFMR) based on severity remain unclear. No studies have systematically evaluated quantitative thresholds, such as effective regurgitant orifice area (EROA) or regurgitant volume, in relation to outcomes in AFMR. This multicentre study aimed to clarify the clinical implications of both qualitative and quantitative assessments of AFMR severity.
View Article and Find Full Text PDFBackground: 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.
Data concerning the clinical effect of the latest-generation self-expandable transcatheter heart valve (Evolut FX) remain limited. We aimed to assess the in-hospital outcomes of 3 bioprosthetic valves (Evolut EPO, PRO+, and FX). We analyzed data from a Japanese multicenter registry involving 634 consecutive patients who underwent transcatheter aortic valve replacement with Evolut FX up until October 2023.
View Article and Find Full Text PDFArticle Synopsis
- Percutaneous left atrial appendage closure (LAAC) helps reduce stroke and bleeding events in patients with non-valvular atrial fibrillation, particularly those who cannot take anticoagulants, but patients with heart failure remain at risk.
- In a study involving 937 patients, researchers evaluated the effect of baseline plasma B-type natriuretic peptide (BNP) levels on outcomes after LAAC, with 98% of the procedures being successfully completed.
- Results showed that higher baseline plasma BNP levels were linked to an increased risk of stroke, bleeding events, and mortality, indicating the need for further research to optimize treatment strategies for these patients.
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.