Association between Sodium-Glucose Co-Transporter-2 Inhibitor Use and Prognosis in Underweight Patients with Diabetes Mellitus and Heart Failure.

Background & Aims: It remains unclear whether sodium-glucose co-transporter-2 (SGLT2) inhibitors are effective for patients with underweight. This study aimed to elucidate the association between SGLT2 inhibitors use and prognosis in underweight patients with diabetes mellitus (DM) and HF.

Methods: This study was a post-hoc analysis of data from the Japanese Registry of Acute Decompensated Heart Failure, a prospective, multicenter, observational, nationwide registry.

Goreisan attenuates cardiac hypertrophy and diastolic dysfunction in heart failure with preserved ejection fraction induced by HFD/L-NAME via regulation of ICAT-β-catenin/ERK axis.

Heart failure with preserved ejection fraction (HFpEF), characterized by cardiac hypertrophy and diastolic dysfunction, is increasing worldwide. Goreisan (GRS) is a traditional herbal formulation; its component attenuates cardiomyocyte hypertrophy. This study aimed to investigate the effect of GRS on the pathophysiology of HFpEF.

Excessive HIF-1α driven by phospholipid metabolism causes septic cardiomyopathy through cytopathic hypoxia.

Septic cardiomyopathy, one manifestation of multiple organ dysfunction syndrome, is a challenging complication in sepsis, and cytopathic hypoxia has been proposed to have a key role in the pathophysiology of multiple organ dysfunction syndrome. However, the underlying mechanisms remain unknown. Here, we show that upregulation of hypoxia-inducible factor-1α (HIF-1α) in cardiomyocytes following lipopolysaccharide (LPS) treatment suppresses mitochondrial respiration via inducible nitric oxide synthase-dependent nitric oxide, leading to cytopathic hypoxia.

Efficacy of Adaptive Servo-Ventilation in Worsening Heart Failure.

Despite advancements in heart failure (HF) therapies, managing symptoms and congestion remains challenging for some patients. Adaptive servo-ventilation (ASV) has been used in Japan to treat residual congestion in chronic HF, but its efficacy remains debated.This study is a subanalysis of the SAVIOR-L study, a multicenter prospective observational study in Japan evaluating ASV in worsening HF.

Long-term surviving intramyocardial dissection following ventricular septal perforation secondary to inferior myocardial infarction with non-surgical treatment.

Unlabelled: A 71-year-old woman was diagnosed with a subacute myocardial infarction caused by an obstruction in the middle segment of the right coronary artery. Two hours after successful percutaneous coronary intervention, bedside transthoracic echocardiography revealed an interventricular septal perforation. Three hours later, the patient developed cardiac tamponade.

iCARDIO Alliance Global Implementation Guidelines on Heart Failure 2025.

Inconsistencies in healthcare access, varying infrastructure, resource constraints and diverse local practices as well as practical and political issues restrict the global applicability of currently available guidelines. There is a need for universal recommendations that address the unique challenges faced by patients and healthcare providers worldwide. Our iCARDIO Alliance Global Implementation Guidelines emphasize the incorporation of novel therapies, while integrating standard of care with the most up-to-date evidence to enable clinicians to optimize patient care.

Activated factor X inhibition ameliorates NF-κB-IL-6-mediated perivascular inflammation and pulmonary hypertension.

Activated factor X (FXa) induces inflammatory response and cell proliferation in various cell types via activation of proteinase-activated receptor-1 (PAR) and/or PAR. We thus aimed to investigate the impact of FXa on the development of pulmonary arterial hypertension (PAH) and the mechanisms involved. The effects of edoxaban, a selective FXa inhibitor, on hemodynamic, right ventricular (RV) hypertrophy, and vascular remodeling were evaluated in a monocrotaline (MCT)-exposed pulmonary hypertension (PH) rat model.

Clinical characteristics and outcomes of hospitalized patients with heart failure from the Japanese prospective registry.

Background: Recent studies showed that clinical parameters other than cardiac function, such as physical function, cognitive function, mental status, social status, and quality of life, were associated with heart failure (HF) prognosis. These parameters have not been extensively investigated in large Japanese cohorts. Furthermore, novel biomarkers to predict prognosis or treatment responses are required to provide individualized medicine.

Survival benefit of primary prevention implantable cardioverter-defibrillator/cardiac resynchronization therapy with a defibrillator: Analysis of the Japan cardiac device treatment registry and Japanese cardiac registry of heart failure in cardiology.

Background: Evidence supporting the benefit from primary prevention implantable cardioverter-defibrillator (ICD)/cardiac resynchronization therapy with a defibrillator (CRT-D) for heart failure with reduced ejection fraction (HFrEF) is scarce in real-world settings.

Methods: We analyzed propensity score matched cohorts of patients eligible for Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) from Japan cardiac device treatment registry (JCDTR) and Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). The former served as the defibrillator therapy group and the latter as the conventional therapy group.

Thymic Carcinoma Invading Bilateral Internal Thoracic Artery Bypass Grafts: Diffuse Stenosis Suggesting Extravascular Compression.

Thymic carcinoma, a rare but aggressively growing malignancy that tends to invade nearby structures, requires early intervention and is often associated with poor prognosis. A 73-year-old man presented with vague chest pain. Imaging studies coincidently revealed an anterior mediastinal mass invading bilateral internal thoracic artery bypass grafts.

Effect of PCSK9 inhibitor usage on coronary endothelial dysfunction in patients with hypercholesterolemia after coronary stenting: The CuVIC-2 trial.

Background: The effects of evolocumab on coronary endothelial dysfunction (CED), a hallmark of atherogenesis, are unknown. The aim of this study was to investigate whether evolocumab, in combination with high-dose statins, could ameliorate CED in patients who underwent coronary stenting.

Methods: The CuVIC-2 trial was a multicenter randomized controlled trial.

2023 Update of the Japanese Heart Failure Society Scientific Statement on BNP and NT-proBNP Levels in Heart Failure Practice.

This revised 2023 statement on blood brain (B-type) natriuretic peptide (BNP) and N-terminal prohormone of brain (B-type) natriuretic peptide (NT-proBNP) represents an expert consensus that aims to enhance efficient referral from general practitioners or non-cardiovascular specialists, providing a comprehensive, up-to-date perspective on BNP and NT-proBNP in the diagnosis and management of heart failure, with a focus on the following two major modifications: (1) Changes regarding cutoff values for BNP and NT-proBNP (criteria for heart failure diagnosis and referral criteria to cardiovascular specialists); and (2) Content related to heart failure management using BNP and NT-proBNP (BNP-guided therapy).

Triglyceride/high density lipoprotein cholesterol index and future cardiovascular events in diabetic patients without known cardiovascular disease.

The triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) index, calculated as TG divided by HDL-C, has been suggested as a predictor of cardiovascular disease (CVD). We investigated the association between the TG/HDL-C index and CVD events in type 2 diabetes mellitus (T2DM) patients with retinopathy and hyperlipidemia but no known CVD, enrolled in the EMPATHY study, which compared intensive and standard statin therapy (targeting LDL-C levels < 70 mg/dL and ≥ 100 to < 120 mg/dL, respectively). A total of 4665 patients were divided into high (TG/HDL-C ≥ 2.

Assessment of frailty in patients with heart failure: A new Heart Failure Frailty Score developed by Delphi consensus.

Aims: The Heart Failure Frailty Score (HFFS) is a novel, multidimensional tool to assess frailty in patients with heart failure (HF). It has been developed to overcome limitations of existing frailty assessment tools while being practical for clinical use. The HFFS reflects the concept of frailty as a multidimensional, dynamic and potentially reversible state, which increases vulnerability to stressors and risk of poor outcomes in patients with HF.

Clinical characteristics and predictive biomarkers of intensive care unit-acquired weakness in patients with cardiogenic shock requiring mechanical circulatory support.

Intensive care unit-acquired weakness (ICU-AW) is recognized as newly-acquired bilateral muscle weakness, which is a complication of critical illness in the ICU; however, there are no reports on the pathogenesis and early predictors of ICU-AW specifically associated with cardiogenic shock (CS). Therefore, this study aimed to investigate the clinical characteristics of ICU-AW in patients with CS requiring mechanical circulatory support (MCS). This study was a single-center, prospective, and observational study.

Association of Multiple Nonhypertrophic Cardiomyopathy-Related Genetic Variants and Outcomes in Patients With Hypertrophic Cardiomyopathy.

Background: Approximately 10% of hypertrophic cardiomyopathy (HCM) patients have left ventricular systolic dysfunction (end-stage HCM) leading to severe heart-failure; however, risk stratification to identify patients at risk of progressing to end-stage HCM remains insufficient.

Objectives: In this study, the authors sought to elucidate whether the coexistence of other cardiovascular disease (CVD)-related variants is associated with progression to end-stage HCM in patients with HCM harboring pathogenic or likely pathogenic (P/LP) sarcomeric variants.

Methods: The authors performed genetic analysis of 83 CVD-related genes in HCM patients from a Japanese multicenter cohort.

Incidence and risk factors of hypotension-related adverse events among Japanese patients with heart failure receiving sacubitril/valsartan or enalapril: Results from the PARALLEL-HF study.

Background: The PARALLEL-HF trial showed that treatment with sacubitril/valsartan resulted in more symptomatic hypotension versus enalapril in Japanese patients with heart failure (HF) and reduced ejection fraction, similar to PARADIGM-HF. Use of sacubitril/valsartan in these patients may be limited by concerns regarding hypotension.

Methods: This post-hoc analysis characterized hypotension-related adverse events (AEs) and their effects on efficacy using data from PARALLEL-HF, in which patients received sacubitril/valsartan 200 mg twice daily or enalapril 10 mg twice daily.