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Why Is Social Reintegration Support for Patients With Left Ventricular Assist Device Necessary?
Pub Date : 2025-02-21 eCollection Date: 2025-03-10 DOI: 10.1253/circrep.CR-25-0004
Tomoko Inoue, Naoya Sakanaka, Misato Ota, Takahisa Noma, Yoichi Yamashita, Taiko Horii, Tetsuo Minamino

Left ventricular assist devices (LVADs) serve as critical life-sustaining therapy for patients with end-stage heart failure awaiting heart transplantation, significantly improving survival rates and enabling social reintegration. However, many patients with LVAD face multiple challenges in their daily lives and social reintegration, such as anxiety about the device, low societal awareness, and economic and psychological burdens. In Japan, where prolonged waiting periods for heart transplants are inevitable, these challenges further exacerbate the economic and psychological burdens on both patients and caregivers. We present the case of a patient with an LVAD who expressed the desire to return to employment after receiving psychological counseling, and discuss the specific outcomes and challenges of employment support. A multidisciplinary team, including physicians, psychologists, and employment specialists, developed an individualized support plan. This led to successful steps toward social reintegration, which was accomplished in collaboration with the workplace. This case highlights the importance of early intervention during the heart transplant waiting period, specifically the LVAD implantation period, along with continuous psychological, economic, and employment support to improve quality of life post-transplant. Establishing a coordinated support system that involves healthcare providers, employers, and local communities is crucial for the successful social reintegration of patients with an LVAD. Specific measures, such as regular mental health counseling and flexible employment arrangements, are essential to achieving this goal.

{"title":"Why Is Social Reintegration Support for Patients With Left Ventricular Assist Device Necessary?","authors":"Tomoko Inoue, Naoya Sakanaka, Misato Ota, Takahisa Noma, Yoichi Yamashita, Taiko Horii, Tetsuo Minamino","doi":"10.1253/circrep.CR-25-0004","DOIUrl":"10.1253/circrep.CR-25-0004","url":null,"abstract":"<p><p>Left ventricular assist devices (LVADs) serve as critical life-sustaining therapy for patients with end-stage heart failure awaiting heart transplantation, significantly improving survival rates and enabling social reintegration. However, many patients with LVAD face multiple challenges in their daily lives and social reintegration, such as anxiety about the device, low societal awareness, and economic and psychological burdens. In Japan, where prolonged waiting periods for heart transplants are inevitable, these challenges further exacerbate the economic and psychological burdens on both patients and caregivers. We present the case of a patient with an LVAD who expressed the desire to return to employment after receiving psychological counseling, and discuss the specific outcomes and challenges of employment support. A multidisciplinary team, including physicians, psychologists, and employment specialists, developed an individualized support plan. This led to successful steps toward social reintegration, which was accomplished in collaboration with the workplace. This case highlights the importance of early intervention during the heart transplant waiting period, specifically the LVAD implantation period, along with continuous psychological, economic, and employment support to improve quality of life post-transplant. Establishing a coordinated support system that involves healthcare providers, employers, and local communities is crucial for the successful social reintegration of patients with an LVAD. Specific measures, such as regular mental health counseling and flexible employment arrangements, are essential to achieving this goal.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 3","pages":"147-153"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiovascular Events During Treatment With Xanthine Oxidoreductase Inhibitors in Patients With Gout and Hyperuricemia in Japan - A JMDC Claims Database Study.
Pub Date : 2025-02-19 eCollection Date: 2025-03-10 DOI: 10.1253/circrep.CR-24-0178
Kazuomi Kario, Seigo Akari, Hiroshi Kanegae

Background: Studies have shown an increased risk of cardiovascular events during treatment with febuxostat vs. allopurinol, but comparative data with another xanthine oxidoreductase inhibitor (XORi), topiroxostat, are lacking. In this retrospective study we compared the incidence of cardiovascular/renal events in Japanese patients with newly diagnosed hyperuricemia and/or gout treated with allopurinol, febuxostat or topiroxostat.

Methods and results: Data came from the JMDC Claims Database from September 2013-September 2019. Participants (n=24,112, age ≥20 years, ≥93% male) were diagnosed with hyperuricemia and/or gout and prescribed XORi treatment in the same month or the following month. Using a Poisson regression model, the adjusted risk (rate ratio [RR]; 95% confidence interval [CI]) of major adverse cardiovascular events was slightly lower with topiroxostat vs. allopurinol (0.63; 0.28-1.41) and febuxostat (0.64; 0.31-1.30). Adjusted risks (RR [95% CI]) for events during treatment with topiroxostat vs. febuxostat and allopurinol were 0.22 [0.10-0.48] and 0.26 [0.11-0.63], respectively, for heart failure, 0.43 [0.27-0.67] and 0.51 [0.31-0.86], respectively, for total cardiovascular events, and 0.46 [0.30-0.69] and 0.62 [0.39-0.98], respectively, for total cardiovascular + renal events. Adjusted risks of atrial fibrillation, heart failure, dialysis, total cardiovascular events, and total cardiovascular + renal events were significantly higher with febuxostat vs. allopurinol.

Conclusions: Topiroxostat may provide a better tolerated option for the treatment of hyperuricemia and/or gout in Japanese patients with respect to cardiovascular events.

{"title":"Cardiovascular Events During Treatment With Xanthine Oxidoreductase Inhibitors in Patients With Gout and Hyperuricemia in Japan - A JMDC Claims Database Study.","authors":"Kazuomi Kario, Seigo Akari, Hiroshi Kanegae","doi":"10.1253/circrep.CR-24-0178","DOIUrl":"10.1253/circrep.CR-24-0178","url":null,"abstract":"<p><strong>Background: </strong>Studies have shown an increased risk of cardiovascular events during treatment with febuxostat vs. allopurinol, but comparative data with another xanthine oxidoreductase inhibitor (XORi), topiroxostat, are lacking. In this retrospective study we compared the incidence of cardiovascular/renal events in Japanese patients with newly diagnosed hyperuricemia and/or gout treated with allopurinol, febuxostat or topiroxostat.</p><p><strong>Methods and results: </strong>Data came from the JMDC Claims Database from September 2013-September 2019. Participants (n=24,112, age ≥20 years, ≥93% male) were diagnosed with hyperuricemia and/or gout and prescribed XORi treatment in the same month or the following month. Using a Poisson regression model, the adjusted risk (rate ratio [RR]; 95% confidence interval [CI]) of major adverse cardiovascular events was slightly lower with topiroxostat vs. allopurinol (0.63; 0.28-1.41) and febuxostat (0.64; 0.31-1.30). Adjusted risks (RR [95% CI]) for events during treatment with topiroxostat vs. febuxostat and allopurinol were 0.22 [0.10-0.48] and 0.26 [0.11-0.63], respectively, for heart failure, 0.43 [0.27-0.67] and 0.51 [0.31-0.86], respectively, for total cardiovascular events, and 0.46 [0.30-0.69] and 0.62 [0.39-0.98], respectively, for total cardiovascular + renal events. Adjusted risks of atrial fibrillation, heart failure, dialysis, total cardiovascular events, and total cardiovascular + renal events were significantly higher with febuxostat vs. allopurinol.</p><p><strong>Conclusions: </strong>Topiroxostat may provide a better tolerated option for the treatment of hyperuricemia and/or gout in Japanese patients with respect to cardiovascular events.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 3","pages":"183-190"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prognostic Value of B-Type Natriuretic Peptide Level in Patients With Heart Failure With a Higher Left Ventricular Ejection Fraction.
Pub Date : 2025-02-08 eCollection Date: 2025-03-10 DOI: 10.1253/circrep.CR-24-0172
Nobuyuki Ohte, Shohei Kikuchi, Noriaki Iwahashi, Yoshiharu Kinugasa, Kaoru Dohi, Hiroyuki Takase, Katsuji Inoue, Takahiro Okumura, Kenta Hachiya, Emiyo Sugiura, Kenya Kusunose, Shuichi Kitada, Yoshihiro Seo

Background: In heart failure (HF) patients with a higher left ventricular ejection fraction (LVEF), the B-type natriuretic peptide (BNP) level is yet to be fully assessed. Accordingly, we hypothesized that the BNP level should be higher in patients with a higher LVEF range based on the previous finding that such patients were associated with a worse prognosis.

Methods and results: In our multicenter, prospective, observational cohort for the composite endpoint of all-cause death and readmission due to HF, including patients with LVEF >40% at hospital discharge, we obtained LVEF, E/e', and BNP levels in 231 patients. The concurrent atrial fibrillation (AF) was confirmed by electrocardiogram. Patients were divided into HF with mildly reduced EF (HFmrEF), HF with preserved EF (HFpEF) with LVEF ≥50 and <60%, and HFpEF with LVEF ≥60%. The BNP levels were not significantly different among these groups (median [interquartile range]: 195 [110-348] vs. 242 [150-447] vs. 220 [125-320] pg/mL, respectively; P=0.422). In contrast, a BNP level of ≥377 pg/mL could significantly differentiate event-free survival (P<0.001). In the multi-covariate Cox proportional hazards model, the BNP level was significantly related to event-free survival independent of LVEF, E/e', and concurrent AF.

Conclusions: Without confounding the effects of LVEF, E/e', and concurrent AF, higher BNP levels are significantly and independently associated with event-free survival in HF patients with LVEF>40%.

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引用次数: 0
Clinical Features of Acute on Chronic Lower Limb Ischemia and the Importance of Underlying Arterial Disease for Revascularization.
Pub Date : 2025-02-07 eCollection Date: 2025-03-10 DOI: 10.1253/circrep.CR-24-0173
Tsutomu Doita, Shinsuke Kikuchi, Yuya Tamaru, Takayuki Uramoto, Kazuki Takahashi, Keisuke Kamada, Seima Ohira, Hiroya Moriyama, Takamitsu Tatsukawa, Naoya Kuriyama, Yuri Yoshida, Daiki Uchida, Keisuke Miyake, Shigeru Miyagawa, Nobuyoshi Azuma

Background: Acute lower extremity limb ischemia (ALI) is a common vascular surgery emergency, primarily caused by embolism or atherosclerotic in situ thrombosis-acute on chronic limb ischemia (AoCLI). This study aimed to examine the clinical features and treatment challenges of AoCLI.

Methods and results: Between January 2014 and December 2022, 73 patients with AoCLI (n=35) or embolic ALI (n=38) were analyzed. The time from ALI onset was significantly longer (P<0.01), and the rate of contralateral diseases was higher in AoCLI than embolic ALI (P<0.01). Treatment and intraoperative findings showed higher rates of failed thrombectomy (P=0.027), difficulty in crossing lesions (P<0.01), defined as failure of Fogarty catheter crossing despite guidewire navigation and requirement of the balloon angioplasty for the lesions, additional revascularization (P<0.01), and multi-segment treatment (P<0.01) in AoCLI. In multivariate analysis, unfavorable factors for endovascular therapy (EVT) were >2.5 days from ALI onset (odds ratio [OR] 1.4; 95% confidence interval [CI] 1.0-2.0), non-atrial fibrillation (OR 4.2; 95% CI 1.0-16.7), and collateral development (OR 9.0; 95% CI 1.0-81.5). Rates of failed EVT were 0% for no factors, 18% for 1 factor, 43% for 2 factors, and 90% for 3 factors.

Conclusions: AoCLI had more complex and multi-segment arterial lesions, making limb perfusion restoration difficult. The unfavorable factors for EVT could help stratify the optimal treatment of ALI in emergency settings.

背景:急性下肢缺血(ALI)是一种常见的血管外科急症,主要由栓塞或动脉粥样硬化性原位血栓形成-急性慢性肢体缺血(AoCLI)引起。本研究旨在探讨AoCLI的临床特征和治疗难题:分析了2014年1月至2022年12月期间73例AoCLI(35例)或栓塞性ALI(38例)患者。从ALI发病时间(P2.5天)、非心房颤动(OR 4.2;95% CI 1.0-16.7)和侧支发展(OR 9.0;95% CI 1.0-81.5)来看,栓塞性ALI患者的时间明显更长。无因素时EVT失败率为0%,有1个因素时为18%,有2个因素时为43%,有3个因素时为90%:结论:AoCLI的动脉病变更复杂、更多节段,因此很难恢复肢体灌注。EVT的不利因素有助于在急诊情况下对ALI的最佳治疗进行分层。
{"title":"Clinical Features of Acute on Chronic Lower Limb Ischemia and the Importance of Underlying Arterial Disease for Revascularization.","authors":"Tsutomu Doita, Shinsuke Kikuchi, Yuya Tamaru, Takayuki Uramoto, Kazuki Takahashi, Keisuke Kamada, Seima Ohira, Hiroya Moriyama, Takamitsu Tatsukawa, Naoya Kuriyama, Yuri Yoshida, Daiki Uchida, Keisuke Miyake, Shigeru Miyagawa, Nobuyoshi Azuma","doi":"10.1253/circrep.CR-24-0173","DOIUrl":"10.1253/circrep.CR-24-0173","url":null,"abstract":"<p><strong>Background: </strong>Acute lower extremity limb ischemia (ALI) is a common vascular surgery emergency, primarily caused by embolism or atherosclerotic in situ thrombosis-acute on chronic limb ischemia (AoCLI). This study aimed to examine the clinical features and treatment challenges of AoCLI.</p><p><strong>Methods and results: </strong>Between January 2014 and December 2022, 73 patients with AoCLI (n=35) or embolic ALI (n=38) were analyzed. The time from ALI onset was significantly longer (P<0.01), and the rate of contralateral diseases was higher in AoCLI than embolic ALI (P<0.01). Treatment and intraoperative findings showed higher rates of failed thrombectomy (P=0.027), difficulty in crossing lesions (P<0.01), defined as failure of Fogarty catheter crossing despite guidewire navigation and requirement of the balloon angioplasty for the lesions, additional revascularization (P<0.01), and multi-segment treatment (P<0.01) in AoCLI. In multivariate analysis, unfavorable factors for endovascular therapy (EVT) were >2.5 days from ALI onset (odds ratio [OR] 1.4; 95% confidence interval [CI] 1.0-2.0), non-atrial fibrillation (OR 4.2; 95% CI 1.0-16.7), and collateral development (OR 9.0; 95% CI 1.0-81.5). Rates of failed EVT were 0% for no factors, 18% for 1 factor, 43% for 2 factors, and 90% for 3 factors.</p><p><strong>Conclusions: </strong>AoCLI had more complex and multi-segment arterial lesions, making limb perfusion restoration difficult. The unfavorable factors for EVT could help stratify the optimal treatment of ALI in emergency settings.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 3","pages":"168-175"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cross-Sectional Study Demonstrating Specificity of Iron Kinetics in Atrial Fibrillation.
Pub Date : 2025-02-06 eCollection Date: 2025-03-10 DOI: 10.1253/circrep.CR-24-0123
Takahiro Kamihara, Shinji Kaneko, Takuya Omura, Kenta Motegi, Akihiro Hirashiki, Manabu Kokubo, Atsuya Shimizu

Background: In the context of cardiovascular disease (CVD), iron metabolism assessment plays a pivotal role in the diagnosis of anemia and chronic inflammation. However, data regarding the prevalence of anemia, iron deficiency, and iron overload among outpatients in real-world clinical settings remain limited. Moreover, the influence of specific diseases on iron kinetics within the CVD spectrum has not been fully elucidated.

Methods and results: We conducted a retrospective analysis of 260 patients attending a cardiology outpatient clinic who had undergone blood sampling for comprehensive evaluation of anemia and iron kinetics. The prevalence of anemia among these outpatients was 36.1%, but iron deficiency was observed in only 13.8% of patients (absolute iron deficiency: 1.5%). Notably, stored iron positively correlated with free iron in patients with sinus rhythm, but not in patients with atrial fibrillation (AF). Intriguingly, this relationship followed a similar pattern in the paroxysmal and longstanding AF subgroups. Moreover, multivariate regression analysis showed that iron dynamics significantly explained hemoglobin levels in patients with sinus rhythm but not in those with AF.

Conclusions: Although chronic inflammation may be a contributing factor, iron dynamics exhibited a distinct profile in patients with AF. The correlation between transferrin saturation and stored iron, evident in sinus rhythm patients, was abolished in AF, which supports the notion of chronic inflammation in patients with AF.

{"title":"Cross-Sectional Study Demonstrating Specificity of Iron Kinetics in Atrial Fibrillation.","authors":"Takahiro Kamihara, Shinji Kaneko, Takuya Omura, Kenta Motegi, Akihiro Hirashiki, Manabu Kokubo, Atsuya Shimizu","doi":"10.1253/circrep.CR-24-0123","DOIUrl":"10.1253/circrep.CR-24-0123","url":null,"abstract":"<p><strong>Background: </strong>In the context of cardiovascular disease (CVD), iron metabolism assessment plays a pivotal role in the diagnosis of anemia and chronic inflammation. However, data regarding the prevalence of anemia, iron deficiency, and iron overload among outpatients in real-world clinical settings remain limited. Moreover, the influence of specific diseases on iron kinetics within the CVD spectrum has not been fully elucidated.</p><p><strong>Methods and results: </strong>We conducted a retrospective analysis of 260 patients attending a cardiology outpatient clinic who had undergone blood sampling for comprehensive evaluation of anemia and iron kinetics. The prevalence of anemia among these outpatients was 36.1%, but iron deficiency was observed in only 13.8% of patients (absolute iron deficiency: 1.5%). Notably, stored iron positively correlated with free iron in patients with sinus rhythm, but not in patients with atrial fibrillation (AF). Intriguingly, this relationship followed a similar pattern in the paroxysmal and longstanding AF subgroups. Moreover, multivariate regression analysis showed that iron dynamics significantly explained hemoglobin levels in patients with sinus rhythm but not in those with AF.</p><p><strong>Conclusions: </strong>Although chronic inflammation may be a contributing factor, iron dynamics exhibited a distinct profile in patients with AF. The correlation between transferrin saturation and stored iron, evident in sinus rhythm patients, was abolished in AF, which supports the notion of chronic inflammation in patients with AF.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 3","pages":"160-167"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pulmonary Artery Denervation for Medication Refractory Pulmonary Hypertension (PARPH Study) - Study Protocol for a Prospective, Open-Label, Single-Arm Clinical Trial.
Pub Date : 2025-02-05 eCollection Date: 2025-03-10 DOI: 10.1253/circrep.CR-24-0179
Ryotaro Asano, Satoshi Nagase, Tatsuo Aoki, Jin Ueda, Akihiro Tsuji, Koko Asakura, Mayumi Fukuda-Doi, Yuko Inoue, Kengo Kusano, Haruko Yamamoto, Takeshi Ogo

Background: Despite the development of effective pulmonary vasodilators, the prognosis for patients with pulmonary hypertension (PH) remains poor, particularly in medication-refractory patients. Catheter-based pulmonary artery denervation (PADN) is an emerging therapeutic strategy targeting the sympathetic nervous system in various types of PH. However, data on its safety and efficacy in refractory patients with PH who truly require non-pharmacotherapy are lacking. Here, we describe a phase II, investigator-initiated, open-label, single-arm trial (Japan Registry of Clinical Trials jRCTs052200017) to evaluate the efficacy and safety of PADN over a 2-year observation period.

Methods and results: Twenty participants will be enrolled and will undergo PADN. The primary endpoint is the time from PADN to the first occurrence of the composite events of death, lung transplantation, and worsening of PH. The safety endpoints are the occurrence of adverse events related to PADN and bradycardia requiring treatment. The exploratory endpoints include right ventricular function evaluated using cardiac magnetic resonance imaging and Short Form-36 score.

Conclusions: The findings of this study will lead to the adoption of PADN for patients with limited treatment options.

背景:尽管开发出了有效的肺血管扩张剂,但肺动脉高压(PH)患者的预后仍然很差,尤其是药物难治性患者。导管肺动脉去神经支配(PADN)是针对各种类型肺动脉高压的交感神经系统的新兴治疗策略。然而,对于真正需要非药物治疗的 PH 难治性患者,还缺乏有关其安全性和有效性的数据。在此,我们介绍一项由研究者发起的开放标签、单臂 II 期试验(日本临床试验登记处 jRCTs052200017),以评估 PADN 在 2 年观察期内的疗效和安全性:将招募 20 名参与者接受 PADN 治疗。主要终点为从 PADN 到首次发生死亡、肺移植和 PH 恶化等综合事件的时间。安全性终点是发生与 PADN 和需要治疗的心动过缓相关的不良事件。探索性终点包括使用心脏磁共振成像和 Short Form-36 评分评估右心室功能:本研究的结果将促使治疗方案有限的患者采用 PADN。
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引用次数: 0
Prefectural Survey on Immune Checkpoint Inhibitor-Associated Myocarditis at the Start of the Basic Plan to Promote Cancer Control Programs - Phase 4.
Pub Date : 2025-02-04 eCollection Date: 2025-03-10 DOI: 10.1253/circrep.CR-24-0171
Yuji Okura, Satoru Miura, Naohito Tanabe, Kazuyuki Ozaki, Takeshi Kashimura, Akira Kikuchi, Tatsuya Takenouchi, Hiroshi Tanaka, Yasuo Saijo, Takayuki Inomata

Background: In 2023, collaboration between cardiologists and oncologists was recommended as part of Japan's Basic Plan to Promote Disease Control Programs for both cancer and cardiovascular diseases. This study explores the extent of this collaboration in Niigata Prefecture.

Methods and results: Self-administered questionnaires about immune checkpoint inhibitor-associated myocarditis (ICIAM) and anthracycline-related cardiomyopathy (ARCM) were distributed to all cardiologists and leading oncologists in hospitals across the Prefecture, of whom 124 cardiologists and 41 oncologists across 29 hospitals responded. Clinical experience with ICIAM was reported by 31.8% of cardiologists and 24.4% of leading oncologists, significantly lower than experience with ARCM (80.0% of cardiologists, P<0.001, and 58.5% of leading oncologists, P=0.009, respectively). Senior cardiologists reported less experience with ICIAM compared with their young counterparts (18.6% vs. 38.5%, P=0.018). Of the 20 hospitals providing immunotherapy, 12 (60%) reported "no consultation" between the cardiology and oncology departments, and only 5 hospitals (25%) had matching answers for consultation after ICIAM onset between these departments. Conversely, only 4 hospitals (20%) answered "no consultation", and 12 hospitals (60%) had matching answers, for interdepartmental consultation before or after ARCM onset.

Conclusions: Compared with ARCM, cardiologists and oncologists had less experience, fewer organized measures in place, and increased interdepartmental collaboration vulnerability with ICIAM. Collaboration between cardiologists and oncologists should be promoted in hospitals.

{"title":"Prefectural Survey on Immune Checkpoint Inhibitor-Associated Myocarditis at the Start of the Basic Plan to Promote Cancer Control Programs - Phase 4.","authors":"Yuji Okura, Satoru Miura, Naohito Tanabe, Kazuyuki Ozaki, Takeshi Kashimura, Akira Kikuchi, Tatsuya Takenouchi, Hiroshi Tanaka, Yasuo Saijo, Takayuki Inomata","doi":"10.1253/circrep.CR-24-0171","DOIUrl":"10.1253/circrep.CR-24-0171","url":null,"abstract":"<p><strong>Background: </strong>In 2023, collaboration between cardiologists and oncologists was recommended as part of Japan's Basic Plan to Promote Disease Control Programs for both cancer and cardiovascular diseases. This study explores the extent of this collaboration in Niigata Prefecture.</p><p><strong>Methods and results: </strong>Self-administered questionnaires about immune checkpoint inhibitor-associated myocarditis (ICIAM) and anthracycline-related cardiomyopathy (ARCM) were distributed to all cardiologists and leading oncologists in hospitals across the Prefecture, of whom 124 cardiologists and 41 oncologists across 29 hospitals responded. Clinical experience with ICIAM was reported by 31.8% of cardiologists and 24.4% of leading oncologists, significantly lower than experience with ARCM (80.0% of cardiologists, P<0.001, and 58.5% of leading oncologists, P=0.009, respectively). Senior cardiologists reported less experience with ICIAM compared with their young counterparts (18.6% vs. 38.5%, P=0.018). Of the 20 hospitals providing immunotherapy, 12 (60%) reported \"no consultation\" between the cardiology and oncology departments, and only 5 hospitals (25%) had matching answers for consultation after ICIAM onset between these departments. Conversely, only 4 hospitals (20%) answered \"no consultation\", and 12 hospitals (60%) had matching answers, for interdepartmental consultation before or after ARCM onset.</p><p><strong>Conclusions: </strong>Compared with ARCM, cardiologists and oncologists had less experience, fewer organized measures in place, and increased interdepartmental collaboration vulnerability with ICIAM. Collaboration between cardiologists and oncologists should be promoted in hospitals.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 3","pages":"176-182"},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing a Collaborative Model for Cardiac Rehabilitation - Linking Hospitals and Local Fitness Centers for Older Adults With Cardiovascular Disease.
Pub Date : 2025-02-04 eCollection Date: 2025-03-10 DOI: 10.1253/circrep.CR-24-0169
Takuya Ozeki, Akihiro Hirashiki, Kakeru Hashimoto, Ikue Ueda, Tatsuya Yoshida, Takahiro Kamihara, Manabu Kokubo, Shigeru Sakakibara, Masaki Wada, Yoshihisa Hirakawa, Hitoshi Kagaya, Susumu Suzuki, Mitsutaka Makino, Hidenori Arai, Atsuya Shimizu

Background: Cardiac rehabilitation (CR) is a comprehensive program designed to help cardiac patients reintegrate into social life. The maintenance phase (phase III) is typically conducted in hospitals or at local exercise facilities, depending on individual lifestyles. Effective collaboration between hospitals and local exercise facilities is essential for maintaining CR in older adults with cardiovascular disease (CVD), but several barriers hinder this linkage.

Methods and results: Since 2022, the Aichi Health Plaza has maintained CR by developing a unique collaboration handbook (the Cardiac Rehabilitation Exercise Facility Cooperation Medical Institutions [CREpas] handbook). A collaboration system was established with the Department of Cardiology at the National Center for Geriatrics and Gerontology, facilitating seamless transitions through referrals after outpatient center-based CR. Partnerships included methods for information sharing, such as a collaboration diary, training records, occasional telephone calls and emails, and biannual information exchange meetings. A total of 18 collaboration patients was enrolled, and no severe adverse events occurred during exercise. However, 11 (61%) of the 18 patients discontinued the program for various reasons.

Conclusions: Transferring CR from hospitals to fitness centers is crucial for older adults with CVD. While safety was ensured at fitness centers, program interruptions highlight the need for addressing barriers to continuity. Seamless healthcare transitions for older CVD patients remain a key challenge in the context of the heart failure pandemic and require further discussion.

背景:心脏康复(CR)是一项综合性计划,旨在帮助心脏病患者重新融入社会生活。根据个人生活方式的不同,维持阶段(第三阶段)通常在医院或当地运动场所进行。医院和当地运动设施之间的有效合作对于维持心血管疾病(CVD)老年人的康复至关重要,但有几个障碍阻碍了这种联系:自 2022 年以来,爱知健康广场通过制定独特的合作手册(《心脏康复锻炼设施合作医疗机构手册》[CREpas])来维持 CR。此外,还与国立老年医学中心的心脏病科建立了合作体系,通过门诊中心 CR 后的转诊,促进无缝过渡。合作方式包括信息共享,如合作日记、培训记录、不定期电话和电子邮件以及一年两次的信息交流会。共有 18 名合作患者参加了培训,培训期间未发生严重不良事件。然而,18 名患者中有 11 人(61%)因各种原因中止了项目:将 CR 从医院转移到健身中心对患有心血管疾病的老年人至关重要。虽然健身中心的安全性得到了保证,但计划的中断凸显了解决连续性障碍的必要性。在心力衰竭大流行的背景下,老年心血管疾病患者的无缝医疗过渡仍是一项关键挑战,需要进一步讨论。
{"title":"Developing a Collaborative Model for Cardiac Rehabilitation - Linking Hospitals and Local Fitness Centers for Older Adults With Cardiovascular Disease.","authors":"Takuya Ozeki, Akihiro Hirashiki, Kakeru Hashimoto, Ikue Ueda, Tatsuya Yoshida, Takahiro Kamihara, Manabu Kokubo, Shigeru Sakakibara, Masaki Wada, Yoshihisa Hirakawa, Hitoshi Kagaya, Susumu Suzuki, Mitsutaka Makino, Hidenori Arai, Atsuya Shimizu","doi":"10.1253/circrep.CR-24-0169","DOIUrl":"10.1253/circrep.CR-24-0169","url":null,"abstract":"<p><strong>Background: </strong>Cardiac rehabilitation (CR) is a comprehensive program designed to help cardiac patients reintegrate into social life. The maintenance phase (phase III) is typically conducted in hospitals or at local exercise facilities, depending on individual lifestyles. Effective collaboration between hospitals and local exercise facilities is essential for maintaining CR in older adults with cardiovascular disease (CVD), but several barriers hinder this linkage.</p><p><strong>Methods and results: </strong>Since 2022, the Aichi Health Plaza has maintained CR by developing a unique collaboration handbook (the <i>Cardiac Rehabilitation Exercise Facility Cooperation Medical Institutions</i> [CREpas] handbook). A collaboration system was established with the Department of Cardiology at the National Center for Geriatrics and Gerontology, facilitating seamless transitions through referrals after outpatient center-based CR. Partnerships included methods for information sharing, such as a collaboration diary, training records, occasional telephone calls and emails, and biannual information exchange meetings. A total of 18 collaboration patients was enrolled, and no severe adverse events occurred during exercise. However, 11 (61%) of the 18 patients discontinued the program for various reasons.</p><p><strong>Conclusions: </strong>Transferring CR from hospitals to fitness centers is crucial for older adults with CVD. While safety was ensured at fitness centers, program interruptions highlight the need for addressing barriers to continuity. Seamless healthcare transitions for older CVD patients remain a key challenge in the context of the heart failure pandemic and require further discussion.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 3","pages":"154-159"},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Myocardial T1 Mapping, Left Ventricular Parameters, and Cardiac Biomarkers in Wild-Type Transthyretin Amyloid Cardiomyopathy Before and After Tafamidis Treatment.
Pub Date : 2025-02-01 eCollection Date: 2025-03-10 DOI: 10.1253/circrep.CR-24-0170
Yuki Ikegami, Toshiro Kitagawa, Yoshiharu Sada, Daiki Okamoto, Kotaro Hamamoto, Fuminari Tatsugami, Kazuo Awai, Yukiko Nakano

Background: To further elucidate the clinical implications of myocardial T1 mapping with cardiac magnetic resonance (CMR) in transthyretin amyloid cardiomyopathy (ATTR-CM), we investigated the relationships of native myocardial T1 value (T1native) and extracellular volume fraction (ECV) with left ventricular (LV) parameters and cardiac biomarkers in ATTR-CM patients before and after tafamidis treatment.

Methods and results: We studied wild-type ATTR-CM patients who underwent baseline CMR with LV cine and T1 mapping techniques. T1native and ECV were derived from averaged values of base-to-apex LV myocardium. Cardiac biomarkers, including high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), were measured at baseline. In a subset of the patients, follow-up CMR was performed and cardiac biomarkers were remeasured 1 year after initiation of tafamidis treatment. Both T1native (n=66) and ECV (n=50) positively correlated with LV end-diastolic volume index, LV mass index, Ln (hs-cTnT), and Ln (NT-proBNP). T1native correlated negatively with LV ejection fraction. Multivariate analysis showed that Ln (hs-cTnT) independently correlated with increased T1native (β=0.32; P=0.033). In the tafamidis follow-up group, changes in T1native (∆T1native) (n=30) and ECV (n=21) after treatment (follow-up-baseline values) negatively correlated with their baseline values. ∆T1native positively correlated with ∆NT-proBNP concentration (r=0.45; P=0.013).

Conclusions: T1native and ECV are comprehensive indicators of LV characteristics in wild-type ATTR-CM patients and may provide imaging-based evidence of meaningful changes after tafamidis treatment.

{"title":"Myocardial T1 Mapping, Left Ventricular Parameters, and Cardiac Biomarkers in Wild-Type Transthyretin Amyloid Cardiomyopathy Before and After Tafamidis Treatment.","authors":"Yuki Ikegami, Toshiro Kitagawa, Yoshiharu Sada, Daiki Okamoto, Kotaro Hamamoto, Fuminari Tatsugami, Kazuo Awai, Yukiko Nakano","doi":"10.1253/circrep.CR-24-0170","DOIUrl":"10.1253/circrep.CR-24-0170","url":null,"abstract":"<p><strong>Background: </strong>To further elucidate the clinical implications of myocardial T1 mapping with cardiac magnetic resonance (CMR) in transthyretin amyloid cardiomyopathy (ATTR-CM), we investigated the relationships of native myocardial T1 value (T1<sub>native</sub>) and extracellular volume fraction (ECV) with left ventricular (LV) parameters and cardiac biomarkers in ATTR-CM patients before and after tafamidis treatment.</p><p><strong>Methods and results: </strong>We studied wild-type ATTR-CM patients who underwent baseline CMR with LV cine and T1 mapping techniques. T1<sub>native</sub> and ECV were derived from averaged values of base-to-apex LV myocardium. Cardiac biomarkers, including high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), were measured at baseline. In a subset of the patients, follow-up CMR was performed and cardiac biomarkers were remeasured 1 year after initiation of tafamidis treatment. Both T1<sub>native</sub> (n=66) and ECV (n=50) positively correlated with LV end-diastolic volume index, LV mass index, Ln (hs-cTnT), and Ln (NT-proBNP). T1<sub>native</sub> correlated negatively with LV ejection fraction. Multivariate analysis showed that Ln (hs-cTnT) independently correlated with increased T1<sub>native</sub> (β=0.32; P=0.033). In the tafamidis follow-up group, changes in T1<sub>native</sub> (∆T1<sub>native</sub>) (n=30) and ECV (n=21) after treatment (follow-up-baseline values) negatively correlated with their baseline values. ∆T1<sub>native</sub> positively correlated with ∆NT-proBNP concentration (r=0.45; P=0.013).</p><p><strong>Conclusions: </strong>T1<sub>native</sub> and ECV are comprehensive indicators of LV characteristics in wild-type ATTR-CM patients and may provide imaging-based evidence of meaningful changes after tafamidis treatment.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 3","pages":"198-206"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Novel Missense Variant of ZC3H12A in Pulmonary Arterial Hypertension.
Pub Date : 2025-01-31 eCollection Date: 2025-03-10 DOI: 10.1253/circrep.CR-25-0007
Ryotaro Asano, Makoto Okazawa, Tomohiko Ishibashi, Xin Ding, Keiko Ohta-Ogo, Kotaro Akaki, Saori Umeki-Mizushima, Akiko Yamagishi, Tadakatsu Inagaki, Ai Yaku, Shinya Fujisaki, Takatoyo Kiko, Kinta Hatakeyama, Osamu Takeuchi, Takeshi Ogo, Yoshikazu Nakaoka

Background: Because Regnase-1, encoded by ZC3H12A, suppresses the development of pulmonary arterial hypertension (PAH) by controlling pro-inflammatory cytokines, we aimed to identify ZC3H12A variants in patients with PAH.

Methods and results: We analyzed whole-genome sequence data of patients with PAH to search for disease-associated ZC3H12A variants. The Regnase-1 p.D426G variant was identified in 2 patients, 1 of whom presented with prominent infiltration of inflammatory cells in the lung. The protein level of the variant was decreased in vitro.

Conclusions: We identified a novel missense variant of ZC3H12A that is directly involved in regulating inflammation in patients with PAH.

{"title":"A Novel Missense Variant of <i>ZC3H12A</i> in Pulmonary Arterial Hypertension.","authors":"Ryotaro Asano, Makoto Okazawa, Tomohiko Ishibashi, Xin Ding, Keiko Ohta-Ogo, Kotaro Akaki, Saori Umeki-Mizushima, Akiko Yamagishi, Tadakatsu Inagaki, Ai Yaku, Shinya Fujisaki, Takatoyo Kiko, Kinta Hatakeyama, Osamu Takeuchi, Takeshi Ogo, Yoshikazu Nakaoka","doi":"10.1253/circrep.CR-25-0007","DOIUrl":"10.1253/circrep.CR-25-0007","url":null,"abstract":"<p><strong>Background: </strong>Because Regnase-1, encoded by <i>ZC3H12A</i>, suppresses the development of pulmonary arterial hypertension (PAH) by controlling pro-inflammatory cytokines, we aimed to identify <i>ZC3H12A</i> variants in patients with PAH.</p><p><strong>Methods and results: </strong>We analyzed whole-genome sequence data of patients with PAH to search for disease-associated <i>ZC3H12A</i> variants. The Regnase-1 p.D426G variant was identified in 2 patients, 1 of whom presented with prominent infiltration of inflammatory cells in the lung. The protein level of the variant was decreased in vitro.</p><p><strong>Conclusions: </strong>We identified a novel missense variant of <i>ZC3H12A</i> that is directly involved in regulating inflammation in patients with PAH.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 3","pages":"207-211"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Circulation reports
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