Publications by authors named "Yuichi Sawayama"
Background: Reversing heparin when managing coronary artery perforation (CAP) during percutaneous coronary intervention (PCI) can provide hemostasis but may cause coronary thrombosis if a device is still present in a coronary artery.
Aims: To assess the impact of heparin reversal while an intracoronary artery device is in place for CAP.
Methods: This study analyzed CAP cases during PCI from January 2006 to October 2023.
Background: Little is known regarding whether ultra-rapid patterns of heart rate variability (eg, heart rate fragmentation [HRF]) are associated with coronary artery calcification (CAC) in a general population.
Objectives: This study aimed to assess the association between HRF and CAC, and whether these associations are independent of systolic blood pressure (SBP) levels.
Methods: From SESSA (the Shiga Epidemiological Study of Subclinical Atherosclerosis), we used data from 24-hour ambulatory blood pressure monitoring to identify awake and asleep SBP levels, and data from concurrent 24-hour Holter monitoring to quantify HRF using the awake and asleep percentage of inflection points (PIP).
Article Synopsis
- Proton pump inhibitors (PPIs), linked to nephrotoxicity, are primarily metabolized by the CYP2C19 enzyme, but how genetic variations affect this risk is not fully understood.
- In a study of patients on PPIs (lansoprazole, esomeprazole, rabeprazole, vonoprazan), poor metabolizers (PM) of CYP2C19 showed a faster decline in kidney function (measured by eGFR) with lansoprazole compared to non-PMs.
- The findings highlight that only lansoprazole metabolizer status impacts renal injury timing, while other PPIs studied did not show significant differences related to CYP2C19 polymorphism.
Article Synopsis
- This study investigated long-term outcomes of alcohol septal ablation (ASA) in 44 Japanese patients with hypertrophic obstructive cardiomyopathy from 1998 to 2022.
- ASA significantly reduced the left ventricular outflow tract pressure gradient and decreased the incidence of moderate or severe mitral regurgitation (MR) post-procedure.
- After a median follow-up of 6 years, moderate or severe MR post-ASA was linked to higher risks of cardiovascular death and heart failure hospitalization; all-cause mortality was 15.1% and 28.9% at 5 and 10 years, respectively.
Aim: Few studies have compared the strength in the associations of anthropometric and computed tomography (CT)-based obesity indices with coronary artery calcification (CAC), aortic artery calcification (AoAC), and aortic valve calcification (AVC).
Methods: We assessed cross-sectcional associations of anthropometric and CT-based obesity indices with CAC, AoAC, and AVC. Anthropometric measures included body mass index (BMI), waist circumference, hip ircumference, waist-to-hip circumference ratio, and waist-to-height ratio in 931 men (mean age, 63.
Article Synopsis
- Left main coronary artery (LMCA) stenosis in coronary artery disease increases the risk of cardiac events, making it crucial to assess its role in ischemia.
- Noninvasive methods like myocardial perfusion scintigraphy (MPS) often provide unreliable results for multi-vessel disease, whereas fractional flow reserve from computed tomography (FFR-CT) shows promise in identifying functional ischemia.
- A case study of a 50-year-old woman demonstrated that FFR-CT effectively identified myocardial ischemia from LMCA stenosis, unlike MPS, highlighting its potential in diagnosing related cardiac issues in patients with right coronary artery hypoplasia.
Article Synopsis
- Acute aortic dissection (AAD) is a serious cardiovascular condition with incidence rates between 2.5 to 7.2 per 100,000 person-years in Western countries, but similar data is missing for Japan.
- A study conducted in Shiga Prefecture over two years enrolled 402 AAD cases, identifying higher age-adjusted incidence rates of 15.8 and 12.2 per 100,000 person-years when compared to Japanese and European populations, respectively.
- The findings revealed that patients with type A-AAD tend to be older and more likely to be female compared to those with type B-AAD.
Background: It is not known whether clopidogrel use in cytochrome P450 (CYP) 2C19 loss-of-function (LOF) carriers with high bleeding risk (HBR) contributes to adverse outcomes after percutaneous coronary intervention (PCI).
Methods and results: This retrospective observational study included 618 consecutive patients with available CYP2C19 polymorphism information who underwent PCI between September 2014 and August 2021. Patients with HBR (319 [52%] met the Academic Research Consortium definition) were divided into 2 groups according to P2Yinhibitor action, namely decreased (i.
Aim: To investigate the incidence and in-hospital mortality of acute myocardial infarction (AMI) by conforming to the Universal Definition of Myocardial Infarction (UDMI) in a population-based registry.
Methods: The Shiga Stroke and Heart Attack Registry is a multicenter, population-based registry in the Shiga Prefecture, designed to evaluate the incidence and prognosis of acute cerebro-cardiovascular diseases. We registered patients with AMI as defined by the UDMI, who developed AMI from January 2014 to December 2015 in the Shiga Prefecture.
Aims: The potential effect of alcohol consumption on coronary heart disease (CHD) remains unclear. We used the variant rs671 in the aldehyde dehydrogenase 2 gene (ALDH2) as an instrument to investigate the causal role of alcohol intake in subclinical and clinical CHD.
Methods: We conducted two Mendelian randomization studies: a cross-sectional study of coronary artery calcification (CAC) on computed tomography of 1029 healthy men (mean age, 63.
Objective: We aimed to investigate the effect of ambulatory blood pressure (BP) on aortic valve calcification (AVC) and coronary artery calcification (CAC), which are subclinical atherosclerotic diseases.
Methods: In this population-based, cross-sectional study, we assessed office BP, mean ambulatory BP (24-h, awake, and asleep), and variability of ambulatory BP, as determined by the coefficient of variation (awake and asleep). AVC and CAC were quantified using an Agatston score (>0) based on computed tomography scanning.
Clinical evidence demonstrating the impact of statins for preventing late target lesion revascularization (TLR) after newer-generation drug-eluting stent implantation and differences in the effect of statins on late TLR according to pre-interventional vessel remodeling and vessel size is limited. We retrospectively evaluated 1193 de novo lesions in 720 patients who underwent everolimus-eluting stent implantation using intravascular ultrasound from January 2010 to December 2012. The primary endpoint was late TLR.
View Article and Find Full Text PDFBackground: An aortic graft implantation is an effective therapeutic method for various aortic diseases. However, it is known that sometimes these implanted grafts can be the foci of infections. Here we report a rare case of graft infection that presented multiple embolisms of aortic branches and peripheral organs.
View Article and Find Full Text PDFAims: School-based routine screenings of electrocardiograms (ECGs) have been performed upon admission to primary school (PS), junior high school (JHS), and high school (HS) in Japan. Though ECGs with prolonged QT intervals are occasionally found, the role of regular ECG screening tests in identifying long QT syndrome (LQTS) remains to be determined. We investigated the usefulness of the ECG screenings by comparing the results of genetic tests between students who showed QT-prolongation in the screenings and patients with LQTS.
View Article and Find Full Text PDFLarge-scale registries have demonstrated that in-hospital mortality after percutaneous coronary intervention (PCI) varies widely across institutions. However, whether this variation is related to major procedural complications (e.g.
View Article and Find Full Text PDFBackground: A cardiac calcified amorphous tumour (CAT) is a non-neoplastic intracavitary cardiac mass. The most serious complication is systemic embolism. Cardiac CATs tend to be surgically resected immediately after detection; therefore, its progress of growth is rarely reported.
View Article and Find Full Text PDFBackground: Ablation using radiofrequency energy has to be carefully performed when the arrhythmia substrate is located in close proximity to the atrioventricular (AV) node due to the risk of inadvertent permanent AV block. The aim of this study was to evaluate the efficacy and safety of catheter-based cryo-therapy for septal accessory pathways (APs).
Methods: A total of eleven patients (median = 56.
Background: The association between cytochrome P450 (CYP) 2C19 genotypes and adverse events in patients treated with clopidogrel or prasugrel after percutaneous coronary intervention (PCI) in the Japanese population is unclear.
Methods and results: This study consisted of 1,580 patients whoseCYP2C19genotypes were assessed at Shiga University of Medical Science Hospital, and 193 clopidogrel-treated and 217 prasugrel-treated patients who were followed more than 1 year after receiving PCI were analyzed. Among 1,580 patients, the prevalence of normal, intermediate, and poor metabolizers was 32%, 49%, and 17%, respectively.