Prognostic value of ultrasound-assessed upper limb muscle thickness on mortality in older patients with heart failure: A post-hoc analysis of the SONIC-HF cohort study.

Background And Aims: Upper limb muscle thickness assessed by ultrasound could be useful to estimate whole body muscle mass. We investigated the association between low upper limb muscle thickness and prognosis in older patients with heart failure (HF).

Methods And Results: This study was a post-hoc analysis of a prospective multicenter cohort, namely, the SONIC-HF study.

Determinants and Clinical Impact of Visit-to-visit Blood Pressure Variability in Patients with Heart Failure with Preserved Ejection Fraction.

Introduction: Blood pressure (BP) affects the prognosis of patients with heart failure with preserved ejection fraction (HFpEF). However, the implications of its variability are poorly understood. This study aimed to explore the determinants and prognostic significance of visit-to-visit BP variability (V2V-BPV) in HFpEF.

Design, Rational, and Baseline Characteristics of the SONIC-HF Multicenter Registry.

Introduction: Skeletal muscle mass and function are crucial for assessing physical frailty, sarcopenia, and cachexia, which significantly impact the prognosis of geriatric patients with heart failure (HF). Ultrasound-based assessment of skeletal muscles offers a non-invasive, real-time alternative to traditional methods. The study (SONIC-HF) aimed to evaluate the feasibility and prognostic impact of ultrasound-based muscle assessment in geriatric patients with HF.

Validation of Guideline Recommendation on Sudden Cardiac Death Prevention in Hypertrophic Cardiomyopathy.

Background: To prevent sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM), the HCM Risk-SCD calculator and guideline recommendations are used to aid decision making for implantable cardioverter-defibrillator placement.

Objectives: The aim of this study was to assess the clinical profiles and occurrence of SCD by phenotypes of HCM and validate the performance of the current guidelines from a large-scale Japanese multicenter registry.

Methods: This was a retrospective, multicenter, observational, longitudinal cohort study that enrolled 3,611 consecutive patients with HCM.

Usefulness of Cardiac Resynchronization Therapy Optimization Using Combined Electrocardiography and Echocardiography.

Introduction Optimization of cardiac resynchronization therapy (CRT) using a 12-lead electrocardiogram (ECG) alone may not sufficiently improve left ventricular (LV) function in all cases. Therefore, we aimed to investigate whether additional optimization using transthoracic echocardiography (TTE) could further enhance CRT efficacy. Methods Sixty-five patients who underwent CRT implantation between March 2018 and July 2022 at Sakakibara Heart Institute, Japan, were included in this study.

Mitral valve early systolic billowing induces following annular expansion and leaflet augmentation in Barlow's disease: sequential analysis using 3D echocardiography.

Aims: Although systolic expansion of the annulus has been recognized in Barlow's disease, the mechanisms of the unique pathological movement of the annulus and its relation to the leaflet augmentation have not yet been clarified. We aimed to investigate the detailed mechanisms of the characteristic mitral apparatus dynamics in Barlow's disease by frame-by-frame sequential geometric analysis using real-time 3D transoesophageal echocardiography.

Methods And Results: Fifty-three patients with Barlow's disease and severe mitral regurgitation without torn chordae, as well as 10 controls, were included.

Dynamic changes in echocardiographic parameters in acute decompensated heart failure: REALITY-ECHO.

Background: Appropriate evaluation of hemodynamic status is vital in the management of acute heart failure (AHF). We aimed to investigate the changes in echocardiographic parameters during very acute phases of AHF and their association with clinical outcomes.

Methods: Patients who were admitted to four Japanese hospitals with AHF were prospectively enrolled.

Efficacy of MitraClip and continued multidisciplinary cardiac rehabilitation in preventing readmission of an older heart failure patient with severe multivalvular disease: A case report.

Unlabelled: The recommendations for the treatment of heart failure patients with severe multivalvular disease are not clear. We present a successful case of an older patient with heart failure and severe multivalvular disease in whom rehospitalization was prevented by a combination of MitraClip implantation (Abbott Vascular, Santa Clara, CA, USA) and continued multidisciplinary cardiac rehabilitation. An 85-year-old male patient presented with New York Heart Association (NYHA) class III severe mitral regurgitation (MR), severe aortic valve regurgitation (AR), and severe tricuspid valve regurgitation (TR).

Flow adjusted transmitral pressure gradient as a modified indicator of functional mitral stenosis after repair for degenerative mitral regurgitation.

Background And Aim: After repair of degenerative mitral regurgitation (DMR), the focus is on functional mitral stenosis (FMS) when there is a decline of mitral hemodynamics. Yet, the clinical impacts and a standardized definition are still undecided. Since common mitral hemodynamic parameters are influenced by transmitral flow, the aim of this study is to seek the impact of flow adjusted transmitral pressure gradient (TMPG) by left ventricular stroke volume (LVSV) on the midterm outcomes.

Sheath shape pattern during leadless pacemaker implantation.

Purpose: Options for shaping the delivery sheath of leadless pacemakers (LPs) based on the cardiac anatomy of patients are limited. We predicted the shape of the LP sheath during implantation using preoperative computed tomography (CT) and intraoperative fluoroscopy.

Methods: Forty-eight patients with implanted LPs due to symptomatic bradyarrhythmia were divided into two groups, α-loop and non-α-loop, based on the shape of the LP delivery sheath head at implantation.

Intraoperative coronary angiography and fractional flow reserve measurement with dobutamine infusion in supra-arterial myotomy for a myocardial bridge: a case report.

Background: A myocardial bridge (MB) is a congenital coronary anomaly, wherein the epicardial coronary artery tunnels through the myocardial band. Treatment is indicated when clinical symptoms occur, and β-blockers are the first choice of treatment. Symptomatic patients refractory to medical therapy are considered for other options, including stent placement, coronary artery bypass grafting, or surgical supra-arterial myotomy.

Physiological and prognostic differences between types of exercise stress echocardiography for functional mitral regurgitation.

Objective: Secondary mitral regurgitation (MR) demonstrates dynamic change during exercise. This prospective observational study aimed to compare exercise stress echocardiography (ESE) where handgrip exercise (handgrip-ESE) or semisupine ergometer exercise was performed (ergometer-ESE) for patients with secondary MR.

Methods: Handgrip-ESE and symptom-limited ergometer-ESE were performed for 53 patients (median age (IQR): 68 (58-78) years; 70% male) on the same day.

Clinical Impact of Flow Adjusted Transmitral Pressure Gradient After Surgical Annuloplasty for Functional Mitral Regurgitation.

Downsizing of mitral annulus due to mitral annuloplasty for ischemic functional mitral regurgitation (FMR) raises a new issue, functional mitral stenosis (FMS), defined as a decline of mitral hemodynamics. However, common mitral hemodynamic parameters are influenced by transmitral flow, therefore, the clinical impacts are still controversial. The aim of this study is to seek mitral hemodynamic indices (including transmitlra pressure gradient [TMPG] adjusted by left ventricular stroke volume [LVSV]) relevant to the mid-term outcomes after annuloplasty for ischemic functional mitral regurgitation (FMR).

Relations of Augmented Systolic Annular Expansion and Leaflet/Papillary Muscle Dynamics in Late-Systolic Mitral Valve Prolapse Evaluated by Echocardiography with a Speckle Tracking Analysis.

The mechanism of systolic annular expansion in mitral valve prolapse (MVP) is not clarified. Since annular expansion is systolic outward shift of MV leaflet/chorda tissue complex at superior and outer ends, annular expansion could be related to inward (superior) shift of the complex at another inferior and inner end of the papillary muscle (PM) tip and/or systolic lengthening of the tissue complex, especially MV leaflets.MV annulus systolic expansion, PMs' systolic superior shift, and MV leaflets' systolic lengthening were evaluated by echocardiography with a speckle tracking analysis in 25 normal subjects, 25 subjects with holo-systolic MVP and 20 subjects with late-systolic MVP.