Publications by authors named "Ryo Nakamaru"

Background: Atrial fibrillation (AF) is managed with various strategies, including rate and rhythm control, to improve patients' health status. Although its incidence increases with age, how age affects health status improvements following AF treatment remains unknown.

Methods: Using data from a multicenter registry for outpatients with newly recognized AF, baseline and 1-year health status was assessed with the Atrial Fibrillation Effect on Quality-of-life quesTionnaire (AFEQT).

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Background: The clinical importance of contrast-associated acute kidney injury (CA-AKI), the most common complication after percutaneous coronary intervention (PCI), is debated.

Objectives: We aimed to assess the association between CA-AKI and long-term outcomes, overall and across the National Cardiovascular Data Registry (NCDR) AKI risk categories.

Methods: We analyzed patients undergoing PCI between September 2008 and October 2021 from a Japanese registry aligned with the NCDR and categorized them by the NCDR AKI risk score tertiles (low-risk [<4.

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Aims: The precise outcomes for patients with residual pulmonary hypertension (PH) following the optimized treatment of acute decompensated heart failure (ADHF) remain poorly understood. This study aimed to investigate the prognostic association of PH, categorized according to left ventricular ejection fraction (LVEF), in hospitalized ADHF patients.

Methods And Results: The WET-HF registry is a multicentre, prospective cohort ADHF registry.

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Background: Pulmonary hypertension (PH) is a common complication of heart failure (HF) that has two subtypes: isolated postcapillary PH (IpcPH) and combined postcapillary and precapillary PH (CpcPH). The definitions of these subtypes were revised in 2022, but the prognostic impacts of this change in hospitalized patients with HF remain unclear. Therefore, this study aimed to investigate how the current definitions of PH subtypes affect patient prognosis.

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Background: Left-sided heart disease is the leading etiology of tricuspid regurgitation (TR) in heart failure (HF); however, the association between different HF phenotypes and the adverse effects of TR remains unclear.

Objectives: The authors aimed to elucidate the association between TR and outcomes across the subtypes of left-sided heart disease in patients hospitalized for HF.

Methods: We analyzed data from the multicenter West Tokyo Heart Failure registry between January 2006 and December 2021.

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Background: With advances in the treatment of heart failure with reduced ejection fraction (HFrEF), the prediction of left ventricular reverse remodeling (LVRR) has become increasingly important. Cardiopulmonary exercise testing (CPET) is a non-invasive test recommended for prognostic risk assessment in HFrEF; however, it is not known whether it predicts LVRR. We aimed to investigate whether the parameters obtained from CPET are useful in predicting LVRR in HFrEF.

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Article Synopsis
  • - The study focused on myofibroblasts and how a vaccine targeting fibroblast activation protein (FAP) might help reduce cardiac fibrosis in mice with chronic cardiac stress.
  • - Mice were vaccinated with a FAP peptide while undergoing continuous treatment with angiotensin II and phenylephrine, resulting in a significant decrease in both cardiac fibrosis and the number of myofibroblasts.
  • - The findings suggest that the FAP vaccine is a promising therapeutic option for cardiac fibrosis without causing harmful side effects in other injury models, indicating its potential for future treatments.
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Patients hospitalized for heart failure (HF) experience impairments in functional status, primarily affecting basic activities of daily living (ADL). We investigated the independent effect of functional status for ADL on patient-centered outcomes (i.e.

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Backgrounds: Heart rate (HR) and stroke volume (SV)-the components of cardiac output-have a complementary relationship. Poor HR increase during exercise is associated with poor exercise tolerance in heart failure (HF) with preserved ejection fraction (HFpEF), but its prognostic impact remains unclear. Furthermore, whether the compensation for poor HR increase with SV during exercise is associated with prognosis remains unknown.

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Background: The increasing prevalence of frailty has gained considerable attention due to its profound influence on clinical outcomes. However, our understanding of the progression of frailty and long-term clinical outcomes in older individuals with atrial fibrillation remains scarce.

Methods: Using data from 2012 to 2018 from a comprehensive claims database incorporating primary and hospital care records in Shizuoka, Japan, we selected patients aged ≥65 years with atrial fibrillation who initiated oral anticoagulant therapy.

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Article Synopsis
  • Current guidelines recommend starting multiple cardioprotective drugs early for patients with heart failure with reduced ejection fraction, but the best order for administering these drugs is not well-established, indicating a need for personalized treatment plans.
  • The LAQUA-HF trial will compare the effects of long-acting versus short-acting loop diuretics alongside different neurohormonal agents, enrolling 240 patients to assess health status changes over 6 months.
  • Ethical approval has been granted for the trial, ensuring informed consent from participants, with results intended for broader dissemination to the medical community.
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Aims: The discontinuation of oral anticoagulants (OACs) remains as a significant concern in the management of atrial fibrillation (AF). The discontinuation rate may vary depending on management strategy, and physicians may also discontinue OACs due to concerns about patient satisfaction with their care. We aimed to assess the incidence of OAC discontinuation and its relationship to patients' health in an outpatient AF registry.

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Aims: The trajectories of systolic function after admission for acute heart failure (HF) and their effect on clinical outcomes have not been fully elucidated. We aimed to assess changes in left ventricular ejection fraction (LVEF) between the index and 1 year after discharge and to examine their prognostic implications.

Methods And Results: We extracted data from a prospective multicentre registry of patients hospitalized for acute HF and identified 1636 patients with LVEF data at admission and 1 year after discharge.

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Long-term outcomes of iatrogenic coronary dissection and perforation in patients undergoing percutaneous coronary intervention (PCI) remains under-investigated. We analyzed 8,721 consecutive patients discharged after PCI between 2008 and 2019 from Keio Cardiovascular (KiCS) PCI multicenter prospective registry in the Tokyo metropolitan area. Significant coronary dissection was defined as persistent contrast medium extravasation or spiral or persistent filling defects with complete distal and impaired flow.

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Article Synopsis
  • Over an 11-year period, a study analyzed trends in clinical management and outcomes for 6,877 hospitalized patients with heart failure (HF).
  • The average age of patients increased from 75.2 to 76.4 years, while the proportion of those with heart failure with reduced ejection fraction (HFrEF) remained stable, and hospital stays lengthened.
  • Notably, the 1-year mortality rate dropped significantly for HFrEF patients, from 18.0% to 9.3%, indicating improved long-term outcomes, while mortality for non-HFrEF patients showed no significant change.
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  • This study evaluated the use of two different access sites, transaxillary/trans-subclavian (TX/TS) and transfemoral (TF), for Impella-assisted patients experiencing cardiogenic shock, using data from the Japanese Percutaneous Ventricular Assist Device registry.
  • Among 2,564 cases, 6.5% utilized the TX/TS approach, which was more common in younger patients and those with specific conditions, like acute coronary syndrome and the use of inotropic medications.
  • The analysis found no significant difference in 30-day mortality rates between the TX/TS (29.3%) and TF (29.6%) approaches, suggesting that TX/TS could be a viable alternative for selected patients needing
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Background: High mortality in patients with acute coronary syndrome (ACS) without standard modifiable cardiovascular risk factors [SMuRFs (e.g. diabetes, hypertension, smoking, and dyslipidemia)] has been reported.

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Background The burden of noncardiovascular conditions is becoming increasingly prevalent in patients with heart failure (HF). We aimed to identify novel phenogroups incorporating noncardiovascular conditions to facilitate understanding and risk stratification in elderly patients with HF. Methods and Results Data from a total of 1881 (61.

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The advances in the integrated management of patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) have reduced subsequent cardiovascular events. Nonetheless, sudden cardiac death (SCD) remains a major concern. Therefore, we aimed to investigate the time trend in SCD incidence after PCI and to identify the clinical factors contributing to SCD.

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Article Synopsis
  • The study investigates long-term outcomes in heart failure patients post-hospitalization, focusing on cardiovascular death (CVD) and non-CVD rates across different age groups and left ventricular ejection fraction (LVEF) classifications.
  • Analyzing 3,558 hospitalized HF patients over a median follow-up of 2 years, results show that non-HFpEF patients have a higher overall death rate compared to HFpEF patients, regardless of age.
  • The study concludes that non-CVD deaths rise with age in both LVEF categories but are more prominent in the HFpEF group, highlighting distinct patterns in mortality risk based on heart failure classification and age.
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We conducted a nonrandomized, open-label phase I study to assess the safety and immunogenicity of an intradermal coronavirus disease 2019 (COVID-19) DNA vaccine (AG0302-COVID-19) administered using a pyro-drive jet injector at Osaka University Hospital between Yanagida November 2020 and December 2021. Twenty healthy volunteers, male or female, were enrolled in the low-dose (0.2 mg) or high-dose (0.

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Background: Recent randomized clinical trials have demonstrated that applying rhythm control during the early stage of atrial fibrillation (AF) may lead to improved clinical outcomes. However, the effects of this modality on health-related quality of life (HRQoL) have not been fully investigated. We aimed to assess the association between the AF stage, determined by the time between AF diagnosis and referral to the cardiology clinic, and HRQoL outcomes.

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To fight against the worldwide COVID-19 pandemic, the development of an effective and safe vaccine against SARS-CoV-2 is required. As potential pandemic vaccines, DNA/RNA vaccines, viral vector vaccines and protein-based vaccines have been rapidly developed to prevent pandemic spread worldwide. In this study, we designed plasmid DNA vaccine targeting the SARS-CoV-2 Spike glycoprotein (S protein) as pandemic vaccine, and the humoral, cellular, and functional immune responses were characterized to support proceeding to initial human clinical trials.

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Background: Pulmonary vein (PV) reconnection is the main cause of atrial fibrillation (AF) recurrence. This study aimed to examine the effect of first-pass PV isolation (PVI) on PV reconnection frequency during the procedure and on AF ablation outcomes.

Methods: This retrospective study included 446 patients with drug-refractory AF (370 men, aged 64 ± 10 years) who underwent initial PVI using an open-irrigated contact force catheter between January 2015 and October 2016.

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Although CD14 has been implicated in the initiation of multiple TLR-mediated inflammatory responses to sepsis and sepsis-related acute lung injury (ALI), an inhibitor of CD14, except for neutralizing Abs, has not been developed. A partial peptide, microglial healing peptide 1 with N-terminal acetylation and C-terminal amidation (MHP1-AcN), derived from the receptor activator of the NF-кB ligand, was recently found to inhibit multiple TLR signaling in the macrophages. Therefore, we hypothesized that the inhibitory effect of MHP1-AcN might be through the inhibition of CD14, a common coreceptor for multiple TLRs.

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