Publications by authors named "Yu Kawada"

Aims: In cardiac amyloidosis (CA), transthyretin-related (ATTR) CA is reported to have more microcalcifications in the interventricular septum (IVS) than other subtypes. This study investigates whether IVS microcalcifications can differentiate CA subtypes.

Methods And Results: A total of 442 patients with CA were enrolled at 18 collaborating institutions of the Japan Cardiac Amyloidosis Survey of typical Echocardiographic findings (J-CASE) Study: 139 light chain/amyloid A (AL/AA) type, 255 wild type ATTR (ATTRwt), 48 variant ATTR (ATTRv), and 19 patients with hypertensive heart disease (HHD).

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Unlabelled: Mitral annular calcification (MAC) is a chronic degenerative process involving the fibrous support structure of the mitral valve. The prevalence of this condition significantly increases with age, and is higher in patients with cardiovascular risk factors or end-stage renal disease. However, patients with systemic lupus erythematosus (SLE) may develop atherosclerosis and MAC at a relatively young age.

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Chronotropic incompetence (CTI), the inability of the heart to increase its rate with increased activity, leads to exercise intolerance and predicts overall mortality. We previously reported that cardiac β-adrenergic receptor downregulation occurs in patients with CTI without heart failure (HF), indicating postsynaptic sympathetic nervous dysfunction. However, cardiac presynaptic sympathetic nervous system function in CTI is not fully understood.

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Transcatheter aortic valve implantation (TAVI) is a proven treatment for severe aortic stenosis (AS); however, the effects of TAVI on central blood pressure (CBP) and clinical outcomes remain unclear. We assessed CBP indices before and after TAVI and their prognostic value. Seventy-six patients with severe AS who underwent TAVI were retrospectively evaluated, and CBP was estimated noninvasively 1 day before and after TAVI.

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Article Synopsis
  • The study investigates the outcomes of patients with cardiogenic shock who received an intra-aortic balloon pump (IABP) followed by an Impella device, revealing a lack of significant difference in 30-day mortality and major complications compared to those receiving Impella as the primary support.
  • Despite initial worse clinical conditions in the IABP-Impella group, after matching for baseline characteristics, the two groups showed comparable outcomes.
  • Notably, the IABP-Impella group had a higher rate of infection and required more additional mechanical support, highlighting potential complications related to the escalation strategy.
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Background: Coronary microvascular dysfunction (CMD) is associated with angina symptoms and adverse clinical outcomes in patients without obstructive coronary artery disease (CAD). Malondialdehyde-modified low-density lipoprotein (MDA-LDL) is reportedly a marker of the initiation and acceleration of epicardial coronary atherosclerosis. However, its impact on CMD remains unclear.

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Background: It is difficult to evaluate adequate dose of heparin for cardiopulmonary bypass (CPB) by activated clotting time (ACT) in a patient receiving both heparin and dabigatran because dabigatran can also prolong ACT. We evaluated the effect of dabigatran by thromboelastography (TEG) to determine adequate heparin dose for CPB.

Case Presentation: An 81-year-old woman receiving both heparin and dabigatran was scheduled for an emergency surgical repair of iatrogenic atrial septal perforation.

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This study aims to develop a new heart failure with preserved ejection fraction (HFpEF) diagnostic algorithm tailored to Asian populations, addressing limitations of current diagnostic models. Existing HFpEF diagnostic algorithms primarily target patients with dyspnea and metabolic comorbidities, such as obesity, which are more prevalent in Western populations. However, in Asian countries, HFpEF cases are less frequently associated with obesity, leading to less prominent dyspnea and more noticeable symptoms such as fatigue.

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Activated arginine vasopressin (AVP) pathway worsens congestion in heart failure (HF), but its potential to relieve pulmonary congestion is also reported. The pathophysiological role and prognostic utility of AVP elevation in acute decompensated HF (ADHF) are poorly understood. We prospectively enrolled 52 hospitalized patients for ADHF to investigate the association between acute lung injury (ALI) in ADHF and AVP levels on admission.

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The prognosis of myocardial infarction with non-obstructive coronary arteries (MINOCA) is reported to be as worse as myocardial infarction with obstructive coronary arteries. However, its mechanical complications are still poorly understood. A 71-year-old woman developed MINOCA after ascending aortic replacement surgery.

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Article Synopsis
  • This study examined the effectiveness of superb microvascular imaging (SMI) for assessing renal circulation in heart failure (HF) patients compared to a control group.
  • Researchers measured vascular index (VI) and intrarenal perfusion index (IRPI) in 71 HF patients undergoing catheterization and found that IRPI could classify patients based on renal congestion status.
  • The findings suggest that IRPI is a significant predictor of renal function, indicating that SMI may aid in evaluating renal perfusion issues in HF.
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Background: The number of patients with heart failure (HF) has increased, and it is crucial to prevent the development of HF in patients at risk of HF. The present study aimed to risk stratify patients in Stage A and B HF based on associations between exercise-induced changes in aortic stiffness and exercise tolerance.

Methods and results: Patients in Stage A and B HF who performed a cardiopulmonary exercise test were enrolled in the study (n=106; median age 65.

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Aim: Adverse limb events after endovascular therapy (EVT) are a major concern. This study aimed to investigate the relationship between serum malondialdehyde-modified low-density lipoprotein (MDA-LDL) level, a potentially potent indicator of atherosclerosis, and clinical outcomes after EVT in patients with lower extremity arterial disease (LEAD).

Methods: A total of 208 LEAD patients who underwent EVT and MDA-LDL measurements were retrospectively analyzed.

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Risk stratification of normal-flow, low-gradient (NFLG) severe aortic stenosis (SAS) with preserved left ventricular (LV) ejection fraction (EF) remains unclear. Of 289 consecutive patients diagnosed with SAS by aortic valve area <1.0 cm, 66 with NFLG-SAS (stroke volume index >35 mL/m, mean pressure gradient <40 mmHg, LVEF ≥50%) were enrolled in this study; patients with bicuspid aortic valve, acute coronary syndrome, hemodialysis, or a history of aortic valve replacement (AVR) were excluded.

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Background: A few studies to evaluate an incidence of bradyarrhythmia in patients with hypertrophic cardiomyopathy (HCM) have been reported.

Methods: We enrolled 161 patients with HCM to evaluate their bradyarrhythmia risk, especially the risk of patients who were at risk for sudden cardiac death (SCD) and eligible for implantation of an implantable cardiac defibrillator (ICD). We defined symptomatic bradyarrhythmia requiring a pacing therapy as a bradyarrhythmia event and collected the data on an occurrence of the event after the time of diagnosis of HCM.

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Background: Left ventricular (LV) ejection fraction (EF) and LV volumes were reported to have prognostic efficacy in cardiac diseases. In particular, the end-systolic volume index (LVESVI) has been featured as the most reliable prognostic indicator. However, such efficacy in patients with LVEF ≥ 50% has not been elucidated.

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A 55-year-old man with esophageal cancer underwent esophagectomy along with lymph node dissection and reconstruction with gastric conduit through the sternal route. He developed a continuous cough with sputum production, 3 years postoperatively. Chest radiography revealed a right middle lung field infiltrate.

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Heart failure (HF) with mid-range left ventricular ejection fraction (LVEF) (HFmrEF) is considered a new category of HF and LVEF < 50%, which is the upper threshold of LVEF for HFmrEF, is thought to represent a mild decrease in LV contractile performance. We aimed to consider an LVEF threshold value to be taken as a surrogate for impairment of LV contractile performance, resulting in new-onset HF. We enrolled 398 patients with LVEF ≥ 40% that underwent cardiac catheterization.

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Impaired glucose metabolism is associated with an increased risk of cardiovascular complications, and coronary artery spasm is thought to underlie the development of coronary artery disease. Intraday glucose variability (GV) accelerates oxidative stress and inflammatory cytokine release, but its impact on coronary artery spasm remains unclear. This study investigated the relationship between intraday GV and coronary artery spasm.

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Cardiac perforation and intracardiac thrombosis are infrequent complications after implantable cardioverter-defibrillator (ICD) implantation, and a case of lead perforation complicated by thrombosis is extremely rare. We report the case of a 66-year-old man with delayed ICD lead perforation concomitant with intracardiac lead thrombosis successfully treated by anticoagulant therapy followed by transvenous lead management.

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Repressive epigenetic modifications, DNA methylation at CpG sites and histone H3 lysine 9 (H3K9) methylation, are enriched in heterochromatin, which undergoes drastic changes in structure during mitosis. MPP8 (M phase phosphoprotein 8) has been proposed to regulate positive association between these two repressive modifications, but actual involvement of this protein in changes in the heterochromatin structure during mitosis remains elusive. We demonstrate here that MPP8 predominantly localized to, but dissociated from, chromatin during interphase and early mitosis, respectively.

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