Patient-centered medical tools for sustained motivation in cardiac rehabilitation of patients with heart failure: protocol of a multicenter randomized controlled trial (EXERCISE-HF trial).

Introduction: Heart failure substantially affects the quality of life of patients and imposes notable social and economic burdens. Despite the beneficial effects of cardiac rehabilitation, global participation rates remain low. Recent advances in wearable biometric technologies may improve patient adherence through real-time monitoring and personalized feedback.

Risk-Stratified Prognostic Implications of Contrast-Associated Acute Kidney Injury After Percutaneous Coronary Intervention.

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.

Residual pulmonary hypertension and clinical outcomes in acute decompensated heart failure patients stratified by left ventricular ejection fraction.

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.

Association Between Mineralocorticoid Receptor Antagonist Use With Worsening Renal Function and Prognosis in Patients With Acute Heart Failure.

Background: Prognostic implications of mineralocorticoid receptor antagonist (MRA) initiation in the context of worsening renal function (WRF) in patients with acute heart failure (AHF) remain unknown.

Methods: This was a post hoc analysis using data from Japanese AHF registries (NARA-HF [Nara Registry and Analyses for Heart Failure], WET-HF [West Tokyo Heart Failure], REALITY-AHF [Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure]). MRA-naïve patients at baseline were included, comprising 1632 patients with HF with reduced ejection fraction (HFrEF) and 2407 with heart failure with mildly reduced or preserved ejection fraction (HFmr/pEF).

Revised definition of pulmonary hypertension subtypes enhances prognostic stratification in hospitalized heart failure patients.

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.

Association of Tricuspid Regurgitation With Mortality in Heart Failure With Left-Sided Heart Disease.

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.

Exercise hemodynamic evaluation in the management of dasatinib-related pulmonary arterial hypertension: a case report.

Background: Dasatinib-related pulmonary arterial hypertension is a rare complication of chronic therapy for hematological malignancies. Pulmonary hypertension often persists despite drug discontinuation and might require vasodilators. Normalizing pulmonary hemodynamics and avoiding the long-term use of vasodilators is challenging.

Finite Element Analysis of a Bare Metal Stent Therapeutic for Aortic Dissection.

Since the endovascular repair for aortic dissection by stent graft still has limitations of the application scope and complications, our group has been developing and evaluating a new stenting function by replacing it with a large self-expandable bare metal stent. In this study, we use finite element analysis to evaluate the remodeling outcomes of the dissected aorta by this new stent. An ideal aortic dissection model was also designed using numerical simulations based on previous animal and in vitro experiments, and then a 32mm bare metal stent was deployed at the location of the lesion.

A Novel Direct Puncture Cannulation Blood Pump Support System: in Vivo Experimental Proof of Concept for a Therapeutic Approach with Cardiac Arrest.

The rate of out-of-hospital cardiac arrest is increasing according to the changes in the proportion of ages in super-aged society. We developed a novel transcutaneous cannulation-type mechanical circulatory system for an alternative therapeutic approach to cardiac arrest using a small centrifugal blood pump. We proposed a transcutaneous mechanical circulatory support capable of rapid installation and quick start of circulatory support for recovery after cardiac arrest by left ventricular direct puncture using the Seldinger technique.

Development and Preliminary Evaluation of a Short-Term Direct Left Ventricular Puncture Type Compact Percutaneous Blood Pump.

Mechanical circulatory support (MCS) devices play a quintessential role in providing hemodynamic support to heart failure patients. The development of short-term compact percutaneous MCS devices which are ideal for emergency acute heart failure applications is one of the promising advances in MCS technologies. This study presents the design and preliminary performance evaluation of a compact percutaneous centrifugal blood pump which is potentially ideal for the quick provision of left ventricular support during emergency cardiac arrest.

Contemporary clinical characteristics and management patterns in hypertrophic cardiomyopathy: insights from baseline enrolment data in a nationwide prospective Japanese registry.

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.

Hospital Variability in the Use of Vasoactive Agents in Patients Hospitalized for Acute Decompensated Heart Failure for Clinical Phenotypes.

Background: The absence of practice standards in vasoactive agent usage for acute decompensated heart failure has resulted in significant treatment variability across hospitals, potentially affecting patient outcomes. This study aimed to assess temporal trends and institutional differences in vasodilator and inotrope/vasopressor utilization among patients with acute decompensated heart failure, considering their clinical phenotypes.

Methods: Data were extracted from a government-funded multicenter registry covering the Tokyo metropolitan area, comprising consecutive patients hospitalized in intensive/cardiovascular care units with a primary diagnosis of acute decompensated heart failure between January 2013 and December 2021.

Cachectic biomarkers as confounders behind the obesity paradox in patients with acute decompensated heart failure.

Background: Obesity is a risk factor for heart failure (HF) development but is associated with a lower incidence of mortality in HF patients. This obesity paradox may be confounded by unrecognized comorbidities, including cachexia.

Methods: A retrospective assessment was conducted using data from a prospectively recruiting multicenter registry, which included consecutive acute heart failure patients.

Possible involvement of vitamin K insufficiency in the progression of cervical ossification of the posterior longitudinal ligament.

Ossification of the posterior longitudinal ligament of the vertebral column (OPLL) is a disease characterised by ectopic bone formation in the spinal ligament that causes progressive neurological impairment. However, there are no suitable treatments for OPLL. Here, we compared the general characteristics and haemostasis of patients with OPLL and those with cervical spondylotic myelopathy.

Electronic Patient-Reported Outcome System Implementation in Outpatient Cardiovascular Care: A Randomized Clinical Trial.

Importance: The integration of patient-reported outcome (PRO) assessments in cardiovascular care has encountered considerable obstacles despite their established clinical relevance.

Objective: To assess the impact of a physician- and patient-friendly electronic PRO (ePRO) monitoring system on the quality of cardiovascular care in clinical practice.

Design, Setting, And Participants: This open-label, multicenter, pilot randomized clinical trial was phase 2 of a multiphase study that was conducted from October 2022 to October 2023 and focused on the implementation and evaluation of an ePRO monitoring system in outpatient clinics in Japan.

Pulmonary arterial hypertension therapies in patients with obesity hypoventilation syndrome: a case series.

Unlabelled: Obesity hypoventilation syndrome is caused by complex interactions between multiple pathological processes, including diminished respiratory drive and sleep-related breathing alterations, leading to structural and functional respiratory impairment and ultimately, pulmonary hypertension. Because pulmonary hypertension is closely associated with obesity hypoventilation syndrome, thoroughly evaluating its etiology is essential, and individualized treatments must be considered. We describe 2 patients with obesity hypoventilation syndrome exhibiting severe pulmonary hypertension with pulmonary vascular resistance exceeding 5 Wood units; both were classified as Group 1 pulmonary hypertension, ie, pulmonary arterial hypertension.

Effect of basic activities of daily living independence on home discharge and long-term outcomes in patients hospitalized with heart failure.

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.

Sweat lactate sensor for detecting anaerobic threshold in heart failure: a prospective clinical trial (LacS-001).

A simple method for determining the anaerobic threshold in patients with heart failure (HF) is needed. This prospective clinical trial (LacS-001) aimed to investigate the safety of a sweat lactate-monitoring sensor and the correlation between lactate threshold in sweat (sLT) and ventilatory threshold (VT). To this end, we recruited 50 patients with HF and New York Heart Association functional classification I-II (mean age: 63.