Clinical impact of mean pulmonary arterial pressure after balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension.

Background: Balloon pulmonary angioplasty (BPA) improves haemodynamics in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Previous studies on BPA have set the treatment objective to achieve a mean pulmonary arterial pressure (mPAP) of <30 mm Hg. However, the clinical impact of mPAP after BPA remains unclear.

Components of particulate matter as potential risk factors for acute myocardial infarction.

Background: Particulate matter with an aerodynamic diameter of ≤2.5 µm (PM) is a heterogeneous mixture, and specific substances that affect cardiovascular events remain unknown. We aimed to examine the association of short-term exposure to PM and its components with hospital admissions for acute myocardial infarction (AMI).

Efficacy and safety of esaxerenone with and without sodium-glucose cotransporter-2 inhibitor use in hypertensive patients with type 2 diabetes mellitus: a pooled analysis of five clinical studies.

This pooled subanalysis of five multicenter, prospective, open-label, single-arm studies on esaxerenone aimed to evaluate the efficacy, organ-protective effects, and safety of esaxerenone in hypertensive patients with type 2 diabetes mellitus (T2DM), with and without concomitant sodium-glucose cotransporter-2 inhibitor (SGLT2i) therapy. In total, 283 and 279 patients were included in the safety (with SGLT2i, 148; without, 135) and full analysis sets (with SGLT2i; 145; without, 134), respectively. Significant changes in morning home systolic/diastolic blood pressure (SBP/DBP) from baseline to Week 12 were shown in the overall population (mean change: -11.

Concurrent Immunoglobulin Light Chain and Transthyretin Cardiac Amyloidosis Patient Treated With Daratumumab and Tafamidis: A Case Report.

Immunoglobulin light chain (AL) and wild-type transthyretin (ATTRwt) amyloidosis, while sharing similar clinical presentations, require distinct treatments. We report a rare case of a 75-year-old man with heart failure diagnosed with concurrent AL and ATTRwt cardiac amyloidosis. Immunohistochemistry and liquid chromatography-tandem mass spectrometry confirmed both AL and ATTR amyloid deposits in the heart.

Can Artificial Intelligence Identify the Ideal Ablation Area for the Patients With Atypical Atrial Flutter? A Proof of Concept Study Using Developed Software.

Background: Catheter ablation for atypical atrial flutter (AFL) is challenging owing to its complex circuit. Consequently, the success rate varies depending on the circuit complexity and the operator's level of experience.

Objective: This study aimed to create software using artificial intelligence to identify the critical isthmus of atypical AFL on 3D mapping.

Real-World Clinical Evidence With Tafamidis in Patients With Transthyretin Amyloid Cardiomyopathy - A Contemporary Review.

Transthyretin amyloid cardiomyopathy (ATTR-CM) is increasingly recognized as a cause of heart failure with preserved ejection fraction in older adults. Tafamidis, a transthyretin stabilizer, is the first disease-modifying therapy approved for ATTR-CM. Although its efficacy was demonstrated in the Tafamidis in Transthyretin Cardiomyopathy Clinical Trial (ATTR-ACT) trial, real-world data are essential to evaluate its effectiveness across broader and more diverse patient populations.

Usefulness of STREI: A new index of right heart function in patients with immunoglobulin light chain cardiac amyloidosis.

Aims: To evaluate the prognostic effect of a novel index by two-dimensional speckle-tracking echocardiography (STREI index) integrating right atrial (RA) and right ventricular (RV) strain in patients with immunoglobulin light chain (AL) cardiac amyloidosis.

Methods: Ninety patients were diagnosed with AL amyloidosis at Kumamoto University Hospital from 2007 to 2022. Among these patients, 70 with evidence of cardiac amyloidosis and sufficient echocardiographic data at diagnosis, including RA and RV strain analysis, were retrospectively analysed.

Quantifying the contributions of cardiovascular risk factors to cardiovascular disease trends in 21st century Japan: a microsimulation study.

Background: Recent stagnation or worsening trends in cardiovascular disease (CVD) risk factors, including low-density lipoprotein cholesterol (LDL-c) and obesity, might slow the decline in Japan's CVD burden. We aimed to quantify the impact of national changes in CVD risk factor distributions on Japan's CVD burden from 2001 to 2019.

Methods: We conducted a microsimulation study with counterfactual analysis using IMPACT, a validated model based on real-world data.

The Effect of Lipid-Lowering Therapy on Coronary Artery Plaque in East Asia Population.

Background: Lipid-lowering therapy (LLT) is important to control atherosclerosis and prevent atherosclerotic cardiovascular disease (ASCVD) events.

Objectives: This study aimed to summarize the effects of LLT on coronary atherosclerotic plaque stability and progression in East Asian individuals.

Methods: A systematic literature search was performed from respective inception dates to November 21, 2023.

Usefulness of the AHEAD score for prediction of all-cause death in patients with acute and chronic coronary syndromes.

Background: The AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score was developed to predict all-cause death (ACD) in patients with heart failure. However, its predictive value for ACD compared to the CHADS score in patients with coronary artery disease (CAD) remains unknown.

Methods: This retrospective multicenter cohort study analyzed data of the patients who underwent percutaneous coronary intervention for acute (ACS) or chronic coronary syndromes (CCS) using the Clinical Deep Data Accumulation System (CLIDAS) database.

Efficacy and safety of esaxerenone in hypertensive patients with chronic kidney disease, with or without type 2 diabetes mellitus: a pooled analysis of five clinical studies.

Effective management of blood pressure (BP) and albuminuria are crucial for suppressing chronic kidney disease (CKD) progression and cardiovascular risks in hypertension. This pooled analysis evaluated the antihypertensive effects, organ-protective effects, and safety of esaxerenone in hypertensive patients with CKD by integrating five clinical studies of esaxerenone. Patients were divided based on type 2 diabetes mellitus (T2DM) status (with or without T2DM) and creatinine-based estimated glomerular filtration rate (eGFR) (30 to <60 and ≥60 mL/min/1.

Drug-Eluting Stent and Drug-Coated Balloon Compared to Full-Covered Drug-Eluting Stent for Femoropopliteal Lesions: CENTAUR Study.

Background: Several studies have documented positive clinical outcomes associated with drug-containing devices, such as drug-eluting stents (DES) and drug-coated balloons (DCB), for femoropopliteal artery (FPA) lesions. Endovascular therapy (EVT) using drug-containing devices is the primary strategy, even for complex FP lesions. However, little is known about the clinical outcomes of the hybrid of DES and DCB therapies.

Efficacy and Safety of High-Intensity Statins in Japanese Patients After Percutaneous Coronary Intervention - Insights From the Clinical Deep Data Accumulation System (CLIDAS).

Background: Lipid-lowering therapy with high-intensity statins has not been widely implemented in Japan for patients with coronary artery disease who undergo percutaneous coronary intervention (PCI). We examined the efficacy and safety of high-intensity statin therapy in a real-world setting.

Methods And Results: We used the Clinical Deep Data Accumulation System (CLIDAS) to accumulate multimodal data from the electronic medical records of 7 cardiovascular centers.

Deep Learning for Cardiac Overload Estimation - Predicting B-Type Natriuretic Peptide (BNP) Levels From Heart Sounds and Electrocardiogram.

Background: B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro-BNP) are key biomarkers used for heart failure (HF) management. Although traditional auscultation lacks objective evaluation, the SSS01-series phonocardiogram enables rapid recording of heart sounds and ECG. We developed a deep-learning model to estimate plasma BNP levels from these non-invasive dynamic physiological signals, with the aim of validating the model's performance with an external validation dataset and assessing its feasibility for clinical application.

Long-term bleeding events post-percutaneous coronary intervention in patients with malignancy with and without anticoagulant therapy.

The prevalence of malignancies in patients undergoing percutaneous coronary intervention (PCI) is increasing with aging. Active malignancy is a significant contributor to high bleeding risk. For cancer patients requiring oral anticoagulant (OAC) therapy, the choice between direct oral anticoagulants (DOAC) and warfarin is critical.

Proton Pump Inhibitor Use, Gastrointestinal Bleeding Reduction, and Long-Term Prognosis After Percutaneous Coronary Intervention.

Proton pump inhibitors (PPI) reduce gastrointestinal bleeding (GIB) after percutaneous coronary intervention (PCI), but their impact on mortality and major adverse cardiovascular events (MACE) remains unclear. This study investigated the association between PPI-related GIB reduction and MACE and mortality using a real-world database. We analyzed 6,457 patients undergoing PCI (2013 to 2019), using the Clinical Deep Data Accumulation System including electronic medical records from 7 Japanese hospitals.

Risk stratification of net adverse clinical events using CHADS-PARC and CHADS scores in chronic coronary syndrome patients without atrial fibrillation: Insights from the CLIDAS-PCI.

Background: There are few data verifying the utility of the CHADS-PARC score in comparison with the CHADS score for estimating net adverse clinical events (NACE) in chronic coronary syndrome (CCS) patients without atrial fibrillation (AF) in real-world settings.

Methods: We performed analysis for a total of 3985 CCS patients without AF who underwent percutaneous coronary intervention (PCI) between April 2013 and March 2019 for whom information was obtained from the CLIDAS (Clinical Deep Data Accumulation System)-PCI database. The primary endpoint was NACE defined as the composite of 3-point major adverse cardiovascular events (3P-MACE) (cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke) and GUSTO moderate/severe bleeding events.

Preventive Effects of Prasugrel on Cerebrovascular Events Following Percutaneous Coronary Intervention.

Background: Dual antiplatelet drug administration is recommended after percutaneous coronary intervention (PCI) stent placement. Although prasugrel, a newer P2Y12 inhibitor, reportedly suppresses cardiovascular events more effectively than the traditional agent clopidogrel, its preventive effects on cerebrovascular disorders remain a topic of ongoing debate. This study aimed to examine the cerebrovascular efficacy and safety of post-PCI prasugrel and clopidogrel using extensive real-world data in Japan.

Rationale, Design, Feasibility, and Profile of the Japanese Circulation Society Chest Pain Registry - Single-Center Pilot Study.

Background: Acute coronary syndrome (ACS) requires prompt diagnosis and treatment. Although "OPQRST" (Onset, Provocation, Quality, Region/Radiation, Symptoms, and Time) is commonly used, the evidence linking emergency department (ED) chest pain characteristics to ACS remains inconclusive. This study evaluated detailed symptoms in ED patients with and without ACS using a broad chest pain registry with symptom data.

Senescence Accelerates the Occurrence of Dual Amyloidosis: Alzheimer's Disease and Wild-Type Transthyretin Amyloidosis.

We report a case of dual amyloidosis with Alzheimer's disease and wild-type transthyretin (ATTRwt) amyloidosis. A 76-year-old man with Alzheimer's disease was referred for anti-amyloid-β therapy with lecanemab. He also had symptoms of congestive heart failure and a history of carpal tunnel syndrome, cubital tunnel syndrome, and lumbar spinal stenosis; raising Technetium-99m pyrophosphate myocardial scintigraphy showed abnormal uptake, and histopathologic examination revealed transthyretin (TTR) amyloid deposition in both myocardial and gastrointestinal biopsy specimens.

Imaging features of wild-type transthyretin amyloid cardiomyopathy in gated and non-gated contrast-enhanced CT.

Objective: Wild-type transthyretin amyloid cardiomyopathy (ATTR-CM) could be common, but its diagnosis is often overlooked. If the imaging features of ATTR-CM can be identified using conventional computed tomography (CT), which is commonly employed in clinical practice, its diagnostic value would be great. This study aimed to assess the imaging features of the condition in conventional non-gated contrast-enhanced CT.