Publications by authors named "Yudai Fujimoto"

Background & Aims: It remains unclear whether sodium-glucose co-transporter-2 (SGLT2) inhibitors are effective for patients with underweight. This study aimed to elucidate the association between SGLT2 inhibitors use and prognosis in underweight patients with diabetes mellitus (DM) and HF.

Methods: This study was a post-hoc analysis of data from the Japanese Registry of Acute Decompensated Heart Failure, a prospective, multicenter, observational, nationwide registry.

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Constrictive pericarditis (CP) is often underdiagnosed, partly because of the lack of established diagnostic criteria. Exaggerated ventricular interdependence during inspiration is a hallmark physiological feature of CP. We herein report the case of a 55-year-old patient with CP who demonstrated a hemodynamic improvement following pericardiectomy.

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Background: Chronic kidney disease (CKD) strongly affects prognosis in patients with heart failure (HF). However, the difference in the implementation of guideline-directed medical therapy (GDMT) during HF-related hospitalization between patients with and without CKD and its association with worsening heart failure (WHF) events remain unclear.

Methods: A post-hoc analysis was conducted using data from a retrospective, multicenter, observational registry of patients hospitalized for HF with a left ventricular ejection fraction (LVEF) of <50 %.

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Background: The dynamics and prognostic value of diuretic metrics in response to initial intravenous (IV) diuretic therapy in patients with acute heart failure (AHF) remain unclear. We assessed the association between urinary sodium concentration, diuretic response (DR) following IV furosemide administration, and their prognostic implications in patients with AHF.

Methods: The diuretic resistance measured by sodium excretion and urine output (DIURESIS)-AHF study was a prospective, multicenter, observational study that assessed spot urinary sodium concentrations at 0/1/2 h, total urine output, and urinary sodium excretion achieved within the first 6 h following initial IV furosemide administration.

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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).

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Background: Adherence to contemporary guideline-directed medical therapy (GDMT) and its association with incident outpatient worsening heart failure (WHF) events after discharge in hospitalized patients with heart failure (HF) remain unclear.

Methods And Results: The PRE-UPFRONT-HF study was a retrospective multicenter observational registry of patients hospitalized for HF between June 2022 and March 2023 with a left ventricular ejection fraction <50%. Data on medications at admission, discharge, and 6 months after admission were collected.

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Aim: Sarcopenia is a prevalent comorbidity among older patients with heart failure. This study aimed to evaluate the differences between sarcopenia diagnosed using the Asian Working Group for Sarcopenia (AWGS) 2014 and 2019 criteria in older patients with heart failure.

Methods: This study is a post hoc sub-analysis of data from the FRAGILE-HF study, a prospective, multicenter, observational study.

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Aims: The prevalence and impact of cardiovascular, kidney, and metabolic (CKM) overlap on physical function and prognosis in older patients with heart failure (HF) remain unclear. This study aimed to assess the impact of overlapping CKM conditions on physical function and prognosis in older patients with HF.

Methods: This post-hoc analysis of the FRAGILE-HF (main cohort) and SONIC-HF (validation cohort), both prospective multicentre studies, included patients aged ≥65 years who were hospitalised for HF.

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[Purpose] This study aimed to clarify the reliability and validity of a skin elasticity meter for evaluating the skin mechanical properties. [Participants and Methods] We conducted a prospective observational study using data from 35 patients diagnosed with unilateral lower extremity edema caused by cancer-related. We evaluated the skin's mechanical properties (relative parameter; R0, distensibility; R2, gross elasticity; R5, net elasticity; R6, viscoelasticity; R7, biological elasticity) of the thigh and lower leg using a skin elasticity meter.

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Purpose: The objective of this study was to determine the standard settings of the angiography system during EVT in Japan.

Methods: Survey requests were mailed to 493 facilities across Japan. The survey items included in the survey were system display dose setting of fluoroscopy dose (FL dose)/digital angiography dose (DA dose)/digital subtraction angiography dose (DSA dose), detector size, fluoroscopy pulse rate, DA/DSA frame rate, and standard additional filter settings.

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As the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors has become widespread, euglycemic diabetic ketoacidosis (EDKA), a rare but notable complication associated with SGLT2 inhibitor use, is gaining attention, although the underlying mechanisms of SGLT2 inhibitor-associated EDKA remain unclear. This report describes the case of a 77-year-old male with type 2 diabetes mellitus on an SGLT2 inhibitor who developed EDKA just after undergoing percutaneous coronary intervention following acute myocardial infarction, with only one day of fasting, despite sufficient insulin secretion. Our case report provides valuable insights into the mechanism and management of SGLT2 inhibitor-associated EDKA in urgent clinical settings.

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Aims: The benefits of exercise in patients with heart failure are well documented. However, to date, the association between exercise habits and prognosis is yet to be evaluated. In this study, we investigated the association between pre-hospital exercise habits and post-discharge prognosis in older adult patients with heart failure.

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Background: Renal dysfunction is significantly associated with poor prognosis in patients with heart failure. However, the prognostic significance of proteinuria as a potential marker of an impaired glomerular filtration barrier in acute heart failure (AHF) remains unclear. We aimed to investigate the prognostic value of urinary protein/creatinine ratio (PCR) in patients with AHF.

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Purpose: The objective of this study is to elucidate the current status of procedural radiation doses for endovascular treatment (EVT) of lower extremity artery disease (LEAD) in Japan and to validate the diagnostic reference level (DRL) quantity.

Methods: Survey requests were mailed to 493 facilities across Japan. The study targeted cases of EVT for LEAD performed between April 1, 2020, and March 31, 2022, with a maximum of 10 cases collected per facility.

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Background And Aims: In patients with heart failure (HF), differences in the association between estimated protein intake (PI) and prognosis in those with and without chronic kidney disease (CKD) remain to be clarified. This study aimed to investigate whether the prognostic effects of the estimated PI differ between patients with HF with and without CKD.

Methods: We included patients who required hospitalisation owing to worsening HF between 2015 and 2019 and assessed the estimated PI based on the adjusted Maroni formula using the body mass index and urinary urea nitrogen level.

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Objectives: The Asian Working Group for Sarcopenia in 2019 (AWGS 2019) emphasized muscle mass measurements. In contrast, the Sarcopenia Definitions and Outcomes Consortium (SDOC) prioritizes functional strength and mobility. Therefore, this study aimed to compare the prognostic utility of the SDOC and AWGS 2019 criteria for all-cause mortality in older patients with heart failure.

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Article Synopsis
  • Older patients (65+) with heart failure (HF) often experience physical frailty and malnutrition, which can worsen each other and lead to poor health outcomes.
  • A study involving 862 hospitalized patients found that those with both frailty and malnutrition had the highest risk of death within a year of discharge compared to those with neither condition.
  • Identifying and addressing both frailty and malnutrition in these patients is essential for improving their overall health and survival rates.
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Malnutrition is known to worsen the prognosis of chronic heart failure (HF). To gain information that may be helpful in establishing appropriate nutritional interventions for chronic HF, this study was performed to investigate the efficacy of nutritional management with 2 enteral formulas, EH, with a standard nutritional composition, and ER, fortified with omega-3 fatty acids, vitamin D, and carnitine. Experiments were performed in a Dahl rat HF model.

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Purpose: This study aimed to determine the combination of factors associated with continuity of care in outpatients with cancer-related edema six months after the initial visit.

Patients And Methods: A total of 101 outpatients were divided into two groups: continuation (n=65) and non-continuation (n=36) groups. Details regarding age, body mass index, sex, affected extremities (upper or lower), site of edema (unilateral or bilateral), International Society of Lymphology (ISL) classification, presence of distant metastasis, and overall score on the lymphedema quality of life questionnaire (LYMQOL) were obtained before initial lymphedema care.

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Article Synopsis
  • Ultrasound measurements of quadriceps muscle thickness (QMT) can be effectively used to assess muscle mass in older heart failure patients, particularly those aged 65 and above.
  • *The study involved 595 hospitalized patients, where QMT was measured with high reliability, demonstrating excellent agreement between different observers.
  • *Findings indicate that lower height-adjusted QMT is linked to higher mortality rates, highlighting its potential as a prognostic tool in heart failure management.*
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Aims: The 6-min walk test (6MWT) is a widely accepted tool for evaluating exercise tolerance and physical capacity, and the 6-min walk distance (6MWD) is an established prognostic factor in patients with heart failure (HF). However, the prognostic implications of post-6MWT dyspnoea remain unknown. We aimed to investigate the prognostic value of Borg scores after the 6MWT in patients with HF.

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Article Synopsis
  • Tricuspid regurgitation (TR) is common in acute heart failure (AHF) and impacts patient prognosis, but the changes in TR severity during hospital stays are not well understood.
  • A study of 1,079 AHF patients found that over half exhibited improvement in TR severity by discharge, with those maintaining severe TR facing worse outcomes like higher mortality and rehospitalization rates.
  • Persistent TR severity after treatment is a significant indicator of poor prognosis, suggesting that ongoing TR may require further treatment in AHF patients upon hospitalization.
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Article Synopsis
  • Hypochloremia, defined as low chloride levels in the blood, is linked to higher mortality rates in heart failure (HF) patients and was studied to see if it enhances existing prognostic models.
  • In a study of 2,496 hospitalized HF patients, those with hypochloremia had a significantly higher 1-year mortality rate (12.6% of patients had hypochloremia, with 15.5% deaths observed).
  • Adding hypochloremia to established risk models improved predictive accuracy, suggesting it can provide valuable insights into patient outcomes post-discharge.
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