Publications by authors named "Itaru Takamisawa"

Transcatheter aortic valve implantation (TAVI) has become available for elderly patients with aortic stenosis (AS). However, no markers have been established to predict prognosis after TAVI. Cardiac damage caused by AS progresses sequentially in most cases through the left ventricle, left atrium, and right ventricle.

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Mitral regurgitation is a prevalent cardiac valvular disease, and its incidence is increasing with the aging population. While surgical intervention has traditionally been the standard treatment for this disease, in Japan, mitral transcatheter edge-to-edge repair (M-TEER) has emerged as a less invasive alternative since 2018. M-TEER demonstrates promising outcomes in reducing postoperative complications and shortening hospital stays.

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Background: In patients with sarcoidosis, cardiac involvement is a crucial prognostic factor leading to severe cardiovascular events. Mitral regurgitation (MR) predisposes patients to drug-refractory heart failure; however, MR in patients with cardiac sarcoidosis (CS) has been scarcely investigated and its therapeutic approach remains unclear. This study aimed to investigate the clinical impact of transcatheter edge-to-edge repair in patients with CS.

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Background: The Japanese Hypertrophic Cardiomyopathy Registry Study was designed to provide comprehensive, real-world insights into the clinical characteristics and management of hypertrophic cardiomyopathy (HCM) in Japan.

Methods: This multicentre, prospective study enrolled consecutive patients with HCM from 24 referral hospitals across Japan starting in 2016. The baseline characteristics of 1485 patients enrolled by December 2019 are presented in this analysis.

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Aims: The nutritional status and frailty are crucial in patients with aortic stenosis undergoing transcatheter aortic valve implantation (TAVI), as they significantly impact outcomes. We have previously developed an easily calculable nutritional index, TCBI (Triglycerides, total Cholesterol, and Body weight Index), which has been validated as a prognostic indicator in various cardiovascular disease contexts. This study aimed to evaluate the impact of a low TCBI on the frailty and outcomes of patients undergoing TAVI.

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Background: The ongoing residual cardiovascular risks despite lowering low-density lipoprotein cholesterol (LDL-C) levels suggest the need to identify additional drivers associated with atherosclerosis. Circulating lipoprotein(a) [Lp(a)] promotes formation of foam cells via its proatherogenic properties. However, whether a lower Lp(a) level in combination with favorable LDL-C control could induce a more stable form of disease remains unknown.

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Background: Owing to the advent of new generation drug-eluting stents, percutaneous coronary intervention (PCI) outcomes are improving. However, the polymers, which have been the most common type of coatings used in drug-eluting stents, have some issues. The study aim was to evaluate the clinical outcomes of patients undergoing PCI with polymer-free sirolimus- and probucol-eluting stents (NP023).

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Preterm birth remains a leading cause of neurodevelopmental disability in offspring, prompting various preventive measures. However, controversies persist surrounding these approaches, particularly regarding beta-mimetic drugs. In Japan, it remains a concerning reality that ritodrine infusion continues to be used for long-term tocolysis in preterm labor, despite the warning issued by the US Food and Drug Administration.

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Background: Valve-related haemolysis is a known complication following prosthetic valve surgery. Haemolysis after transcatheter aortic valve implantation (TAVI) has been reported in some studies, all of which were non-critical. Data related to haemolysis associated with new-generation balloon-expandable valve (BEV) are scarce.

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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.
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Article Synopsis
  • A history of hospitalization for heart failure (HHF) before transcatheter aortic valve implantation (TAVI) is linked to poorer clinical outcomes in patients with severe aortic stenosis (AS).
  • In a study of 2,752 patients, those with prior HHF had significantly higher 30-day mortality and overall risk of negative outcomes compared to those without such a history.
  • The findings highlight that prior HHF affects patients regardless of their heart function, emphasizing the need for careful evaluation and management in these cases post-TAVI.
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Article Synopsis
  • * Recent findings emphasize that the mitral valve, papillary muscle issues, and an apical-basal muscle bundle also contribute significantly to this obstruction, not just the typical septal hypertrophy.
  • * Four-dimensional computed tomography is recommended for detailed assessment and planning of surgical intervention in HCM, offering better imaging capabilities than traditional methods like echocardiography or cardiac MRI.
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Low body weight and advanced age are among the best predictors of osteoporosis. Osteoporosis Self-Assessment Tool (OST) values are calculated by a simple formula [(body weight in kilograms - age in years) × 0.2] to identify patients at increased risk of osteoporosis.

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The number of patients who underwent transcatheter aortic valve implantation (TAVI) with the potential for reintervention is steadily increasing; however, there is a risk of sinus sequestration (SS) during a redo TAVI. The prevalence, predictors, and risk stratification of the risk for SS remain uncertain. We analyzed computed tomography acquired from 263 patients who underwent TAVI between 2021 and 2022: balloon-expandable valve (BEV) (71%) and self-expandable valve (SEV) (29%).

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Background: It remains unclear whether clopidogrel is better suited than aspirin as the long-term antiplatelet monotherapy following dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI).

Objectives: This study compared clopidogrel monotherapy following 1 month of DAPT (clopidogrel group) with aspirin monotherapy following 12 months of DAPT (aspirin group) after PCI for 5 years.

Methods: STOPDAPT-2 (Short and Optimal Duration of Dual Antiplatelet Therapy 2) is a multicenter, open-label, adjudicator-blinded, randomized clinical trial conducted in Japan.

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Objective: Transcatheter balloon aortic valvuloplasty (BAV) remains an important alternative treatment for severe, symptomatic aortic stenosis. With increasing numbers of BAVs being performed, the need for large-scale volume-outcome relationship assessments has become evident. Here, we aimed to explain such relationships by analysing consecutive, patient-level BAV data recorded in a prospective Japanese nationwide multicentre registry.

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Unlabelled: A 74-year-old man who had undergone surgical aortic valve replacement with the SOLO SMART stentless bioprosthetic valve 25 mm (LivaNova PLC, London, UK) and mitral valve replacement with MOSAIC 29 mm (Medtronic, Minneapolis, USA) 4 years previously was diagnosed with congestive heart failure, and transferred to our hospital. Echocardiography revealed severe aortic regurgitation caused by degraded bioprosthetic valve. He required continuous dobutamine administration to maintain hemodynamics.

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