Impact of renal function on the efficacy of low-voltage area ablation after pulmonary vein isolation: A sub-analysis of the SUPPRESS-AF trial.

Background And Aims: The SUPPRESS-AF trial showed that pulmonary vein isolation (PVI) plus low-voltage area (LVA) ablation may reduce atrial fibrillation (AF) recurrence in some subgroups. Renal dysfunction is a cause of LVAs due to atrial cardiomyopathy and is also a risk factor for AF recurrence after catheter ablation. The aim of this study was to investigate the efficacy of LVA ablation after PVI stratified by renal function.

Trends in Characteristics and Treatment of Patients With Chronic Limb-Threatening Ischemia Undergoing Endovascular Therapy.

Background: Due to an aging population and the growing prevalence of diabetes, patients with chronic limb-threatening ischemia (CLTI) represent a growing burden on health care and social services.

Objectives: This study aimed to investigate the trends in characteristics and treatment of patients with CLTI.

Methods: This multicenter retrospective study included 2,085 patients with CLTI who underwent endovascular therapy between April 2010 and March 2023.

Association of Risk Factors and Cardiac Outcomes in Patients With Primary Prevention of Sudden Cardiac Death: HINODE Study Sub Analysis.

Introduction: Primary analysis of the HINODE study revealed that mortality and ventricular tachyarrhythmia event rates for patients with primary prevention of sudden cardiac death in Japan were comparable to those of Western patients. Sub-analysis aimed to evaluate event rates in relation to accumulated risk factors (RFs) (left ventricular ejection fraction ≤ 35%, New York Heart Association class III/IV, left bundle branch block/wide QRS, renal dysfunction, diabetes, atrial fibrillation, myocardial infarction, age > 70 years, and smoking).

Methods And Results: Implantable cardioverter defibrillator (ICD) (N = 102) and cardiac resynchronization therapy-defibrillator (CRT-D) (N = 69) enrollees were evaluated for first appropriately treated ventricular tachycardia or fibrillation (VT/VF), recurrent heart failure (HF) hospitalizations, and all-cause mortality.

Successful fluoroquinolone-based salvage therapy in the conservative management of refractory infective endocarditis caused by in an elderly patient: a case report.

Infective endocarditis (IE) is a life-threatening condition, often requiring surgical intervention; however, in cases where surgery is contraindicated, conservative management relies on appropriate antibiotic therapy. Moreover, modification of antibiotics can be critical, as certain agents may be superior in resolving infection and associated complications. We present the case of an 88-year-old woman with IE due to , successfully treated with oral antibiotics.

Electrical isolation of the cavotricuspid isthmus aneurysm: a novel strategy for refractory atrial tachyarrhythmias with complex anatomical variants: a case report.

Background: Cavotricuspid isthmus (CTI) is a part of the re-entrant circuit of atrial flutter (AFL), and its linear ablation is the method of choice for treating CTI-dependent AFL. We describe our experience of a case of multiple atrial tachycardias (ATs) originating from the CTI aneurysm and the challenges encountered during its electrophysiological management.

Case Summary: The patient, a 61-year-old woman with hereditary non-polyposis colorectal cancer, presented with recurrent supraventricular tachycardia resistant to conventional treatment with anti-arrhythmic medication and electrical cardioversion.

Subphenogroups of acute heart failure with preserved ejection fraction: comprehensive proteomics and pathway analysis.

Background: Heterogeneity of heart failure with preserved ejection fraction (HFpEF) results in significant challenges for treatment development. Identifying and characterising distinct HFpEF phenogroups may aid in tailoring therapeutic strategies for these patients. The objective of this study was to assess proteomic patterns of HFpEF phenogroups identified through a machine-learning-based clustering model, with the aim of uncovering specific biological pathways associated with each phenogroup.

Left Atrial Volumetric/Mechanical Coupling Index in Heart Failure With Preserved Ejection Fraction.

Background: Left atrial (LA) dysfunction is common in heart failure with preserved ejection fraction (HFpEF). The LA volumetric/mechanical coupling index (LACI), calculated as the LA volume index divided by the late diastolic mitral annular velocity (a'), is a recently advocated parameter reflecting LA contractile function based on the atrial Frank-Starling mechanism. An elevated LACI signifies impaired mechanical performance despite greater atrial volume, indicating volumetric/mechanical uncoupling.

Impact of Femoropopliteal Drug-Coated Balloon Use on Clinical Outcomes in Patients With Chronic Limb-Threatening Ischemia.

Background: Drug-coated balloons (DCBs) for femoropopliteal (FP) lesions have demonstrated superiority over standard percutaneous transluminal angioplasty (PTA) in maintaining vessel patency. However, data on whether the good durability of DCBs translates into improved wound outcome in chronic limb-threatening ischemia (CLTI) patients are limited.

Aims: The aim of this study was to compare the effectiveness of FP-DCBs with that of standard PTA in achieving superior wound healing outcomes in CLTI patients.

Four-dimensional flow magnetic resonance imaging assessment of left ventricular hemodynamics in transplanted hearts with good postoperative course.

Heart transplantation (HTx) is an established treatment for patients with advanced heart failure, although postoperative rejection responses hamper favorable long-term treatment outcomes. Medical imaging is a non-invasive diagnostic modality that can provide attractive insights into cardiac physiology for HTx, including morphological characteristics and cardiac hemodynamics. This study aimed to achieve a basic understanding of left ventricular (LV) hemodynamics in patients with good treatment outcomes following HTx.

Resolution of oral anticoagulation-resistant left atrial appendage thrombus by cardiac resynchronization therapy and atrioventricular nodal ablation.

Unlabelled: We present a case of congestive heart failure with reduced ejection fraction complicated by atrial tachycardia and an oral anticoagulation-resistant left atrial appendage (LAA) thrombus. The LAA thrombus prevented sinus rhythm restoration, and the ventricular rate control was also difficult. Cardiac resynchronization therapy (CRT)-defibrillator implantation followed by atrioventricular nodal ablation was performed, and the patient's congestive heart failure improved.

Comparison between DOACs and warfarin for left atrial thrombus in atrial fibrillation patients.

Background: Atrial fibrillation (AF) is a major risk factor for thromboembolic events, with left atrial thrombus (LAT) formation occurring despite oral anticoagulant (OAC) therapy in some patients. Direct oral anticoagulants (DOACs) have demonstrated efficacy in preventing thrombosis; however, their role in LAT resolution compared to warfarin remains unclear.

Methods: This retrospective, multicenter study analyzed 260 AF patients with transesophageal echocardiography (TEE)-confirmed LAT among 17,436 AF patients who underwent TEE.

Long-term prognosis after acute coronary syndrome due to de novo coronary artery lesions and stent thrombosis in patients on hemodialysis.

Percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) undergoing hemodialysis (HD) remains challenging, with limited long-term outcome data. We investigated the long-term prognosis of ACS due to de novo coronary artery lesions and stent thrombosis (ST) in patients with and without HD. We analyzed 187 patients with ACS from the Osaka Cardiovascular Conference Long ST registry, a retrospective, multicenter registry of definite ST, and 1,856 patients with ACS due to de novo coronary artery lesions at Kansai Rosai Hospital.

Serum Desmosterol Level Reflects Hepatic Inflammation Grade in Patients with Biopsy-Confirmed Metabolic Dysfunction-Associated Steatotic Liver Disease.

Aim: Desmosterol, a cholesterol precursor, is converted by Δ24-dehydrocholesterol reductase. Hence, desmosterol levels are considered to reflect cholesterol metabolism. This study aimed to evaluate sterols as novel biomarkers of liver condition in Asian moderate obese patients with metabolic dysfunction-associated steatotic liver disease (MASLD).

Usefulness of Respiratory Stability Time-Guided Management to Prevent Readmission of Chronic Heart Failure Patients at Home: A Multicenter, Single-Arm, Open-Label Clinical Study (ITMETHOD-HF-III).

: Telemonitoring aimed at detecting subclinical heart failure and facilitating medication up-titration offers a promising approach to reducing heart failure hospitalizations. Our team has recently developed a non-invasive metric called "respiratory stability time (RST)", which quantifies respiratory instability, a surrogate marker of subclinical worsening heart failure. A decrease in RST below 20 s predicts the onset of worsening heart failure within 28 days.

Estimation of Coronary Obstruction Risk for the Transcatheter Aortic Valve Implantation in Surgical Aortic Valve (TAV-in-SAV) Procedure.

Background: To consider transcatheter aortic valve-in-surgical aortic valve (TAV-in-SAV) as a secondary intervention, the risk of coronary obstruction during future TAV-in-SAV should be assessed prior to initial SAV replacement (SAVR), especially in Japanese patients with a small body size and aortic root anatomy. In this study we simulated the risk of coronary obstruction and identified associated anatomical factors.

Methods And Results: We retrospectively analyzed pre- and post-SAVR computed tomography scans of 115 patients and simulated the risk of coronary obstruction.

Renal Function and its Time-Sensitive Influence on Survival Rates of Acute Myocardial Infarction.

Background: Primary percutaneous coronary intervention is the preferred treatment for acute myocardial infarction. However, in patients with chronic kidney disease (CKD), the use of contrast media can exacerbate renal dysfunction, often necessitating alternative strategies. The impact of CKD on acute myocardial infarction prognosis, particularly in the context of percutaneous coronary intervention, is not fully understood.

Prognostic utility of advanced lung cancer inflammation index in heart failure with preserved ejection fraction.

Aims: Malnutrition and inflammation are associated with poor outcomes with heart failure (HF). As a marker integrating inflammation and nutritional status, the advanced lung cancer inflammation index (ALI), calculated by body mass index × serum albumin level / neutrophil-to-lymphocyte ratio, has been developed for the prognosis of several diseases including HF. The aim of this study is to investigate the prognostic value of ALI in elderly multimorbid HF patients with HF with preserved ejection fraction (HFpEF).

Clinical Phenotypes of Patients With Ischemic Cardiomyopathy After Percutaneous Coronary Intervention.

Background: Percutaneous coronary intervention (PCI) is a good option for patients with ischemic cardiomyopathy (ICM) at high operative risk. However, evidence shows little benefit of PCI, potentially due to heterogeneity in ICM. Here, we applied latent class analysis (LCA) to clinical data to characterize ICM phenotypes based on clinical features and to assess differences in clinical outcomes.