著者

Eiji Hiraoka Kengo Tanabe Shinichiro Izuta Tadao Kubota Shun Kohsaka Amane Kozuki Kazuhiro Satomi Hiroki Shiomi Toshiro Shinke Toshiyuki Nagai Susumu Manabe Yasuhide Mochizuki Taku Inohara Mitsuhiko Ota Tetsuma Kawaji Yutaka Kondo Yumiko Shimada Yohei Sotomi Tomofumi Takaya Atsushi Tada Tomohiko Taniguchi Kazuya Nagao Kenichi Nakazono Yukiko Nakano Kazuhiko Nakayama Yuichiro Matsuo Takashi Miyamoto Yoshinao Yazaki Kazuyuki Yahagi Takuya Yoshida Kohei Wakabayashi Hideki Ishii Minoru Ono Akihiro Kishida Takeshi Kimura Tetsuro Sakai Yoshihiro Morino on behalf of the Japanese Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0609, (Released:2023-08-10)

参考文献数

439

被引用文献数

7

著者

Hiroyuki Tsutsui Mitsuaki Isobe Hiroshi Ito Hiroshi Ito Ken Okumura Minoru Ono Masafumi Kitakaze Koichiro Kinugawa Yasuki Kihara Yoichi Goto Issei Komuro Yoshikatsu Saiki Yoshihiko Saito Yasushi Sakata Naoki Sato Yoshiki Sawa Akira Shiose Wataru Shimizu Hiroaki Shimokawa Yoshihiko Seino Koichi Node Taiki Higo Atsushi Hirayama Miyuki Makaya Tohru Masuyama Toyoaki Murohara Shin-ichi Momomura Masafumi Yano Kenji Yamazaki Kazuhiro Yamamoto Tsutomu Yoshikawa Michihiro Yoshimura Masatoshi Akiyama Toshihisa Anzai Shiro Ishihara Takayuki Inomata Teruhiko Imamura Yu-ki Iwasaki Tomohito Ohtani Katsuya Onishi Takatoshi Kasai Mahoto Kato Makoto Kawai Yoshiharu Kinugasa Shintaro Kinugawa Toru Kuratani Shigeki Kobayashi Yasuhiko Sakata Atsushi Tanaka Koichi Toda Takashi Noda Kotaro Nochioka Masaru Hatano Takayuki Hidaka Takeo Fujino Shigeru Makita Osamu Yamaguchi Uichi Ikeda Takeshi Kimura Shun Kohsaka Masami Kosuge Masakazu Yamagishi Akira Yamashina on behalf of the Japanese Circulation Society and the Japanese Heart Failure Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.10, pp.2084-2184, 2019-09-25 (Released:2019-09-25)

参考文献数

608

被引用文献数

435

著者

Hiroyuki Tsutsui Tomomi Ide Hiroshi Ito Yasuki Kihara Koichiro Kinugawa Shintaro Kinugawa Miyuki Makaya Toyoaki Murohara Koichi Node Yoshihiko Saito Yasushi Sakata Wataru Shimizu Kazuhiro Yamamoto Yasuko Bando Yu-ki Iwasaki Yoshiharu Kinugasa Isamu Mizote Hitoshi Nakagawa Shogo Oishi Akiko Okada Atsushi Tanaka Takashi Akasaka Minoru Ono Takeshi Kimura Shun Kosaka Masami Kosuge Shin-ichi Momomura on behalf of the Japanese Circulation Society and the Japanese Heart Failure Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0431, (Released:2021-09-29)

参考文献数

252

被引用文献数

84

著者

Hitoshi Ogino Osamu Iida Koichi Akutsu Yoshiro Chiba Hiromitsu Hayashi Hatsue Ishibashi-Ueda Shuichiro Kaji Masaaki Kato Kimihiro Komori Hitoshi Matsuda Kenji Minatoya Hiroko Morisaki Takao Ohki Yoshikatsu Saiki Kunihiro Shigematsu Norihiko Shiiya Hideyuki Shimizu Nobuyoshi Azuma Hirooki Higami Shigeo Ichihashi Toru Iwahashi Kentaro Kamiya Takahiro Katsumata Nobuyoshi Kawaharada Yoshihisa Kinoshita Takuya Matsumoto Shinji Miyamoto Takayuki Morisaki Tetsuro Morota Kiyonori Nanto Toshiya Nishibe Kenji Okada Kazumasa Orihashi Junichi Tazaki Masanao Toma Takuro Tsukube Keiji Uchida Tatsuo Ueda Akihiko Usui Kazuo Yamanaka Haruo Yamauchi Kunihiro Yoshioka Takeshi Kimura Tetsuro Miyata Yutaka Okita Minoru Ono Yuichi Ueda on behalf of the Japanese Circulation Society the Japanese Society for Cardiovascular Surgery the Japanese Association for Thoracic Surgery and the Japanese Society for Vascular Surgery Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0794, (Released:2023-09-01)

参考文献数

1943

被引用文献数

13

著者

Minoru Ono Osamu Yamaguchi Tomohito Ohtani Koichiro Kinugawa Yoshikatsu Saiki Yoshiki Sawa Akira Shiose Hiroyuki Tsutsui Norihide Fukushima Goro Matsumiya Masanobu Yanase Kenji Yamazaki Kazuhiro Yamamoto Masatoshi Akiyama Teruhiko Imamura Kiyotaka Iwasaki Miyoko Endo Yoshihiko Ohnishi Takahiro Okumura Koichi Kashiwa Osamu Kinoshita Kaori Kubota Osamu Seguchi Koichi Toda Hiroshi Nishioka Tomohiro Nishinaka Takashi Nishimura Toru Hashimoto Masaru Hatano Haruhiko Higashi Taiki Higo Takeo Fujino Yumiko Hori Toru Miyoshi Motoharu Yamanaka Takayuki Ohno Takeshi Kimura Shunei Kyo Yasushi Sakata Takeshi Nakatani on behalf of the JCS/JSCVS/JATS/JSVS Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0880, (Released:2022-04-05)

参考文献数

288

被引用文献数

10

著者

Masato Nakamura Hitoshi Yaku Junya Ako Hirokuni Arai Tohru Asai Taishiro Chikamori Hiroyuki Daida Kiyoshi Doi Toshihiro Fukui Toshiaki Ito Kazushige Kadota Junjiro Kobayashi Tatsuhiko Komiya Ken Kozuma Yoshihisa Nakagawa Koichi Nakao Hiroshi Niinami Takayuki Ohno Yukio Ozaki Masataka Sata Shuichiro Takanashi Hirofumi Takemura Takafumi Ueno Satoshi Yasuda Hitoshi Yokoyama Tomoyuki Fujita Tokuo Kasai Shun Kohsaka Takashi Kubo Susumu Manabe Naoya Matsumoto Shigeru Miyagawa Tomohiro Mizuno Noboru Motomura Satoshi Numata Hiroyuki Nakajima Hirotaka Oda Hiromasa Otake Fumiyuki Otsuka Ken-ichiro Sasaki Kazunori Shimada Tomoki Shimokawa Toshiro Shinke Tomoaki Suzuki Masao Takahashi Nobuhiro Tanaka Hiroshi Tsuneyoshi Taiki Tojo Dai Une Satoru Wakasa Koji Yamaguchi Takashi Akasaka Atsushi Hirayama Kazuo Kimura Takeshi Kimura Yoshiro Matsui Shunichi Miyazaki Yoshitaka Okamura Minoru Ono Hiroki Shiomi Kazuo Tanemoto on behalf of the Japanese Circulation Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-1282, (Released:2022-01-31)

参考文献数

1179

被引用文献数

38

著者

Hirokai Kitaoka Hiroyuki Tsutsui Toru Kubo Tomomi Ide Taishiro Chikamori Keiichi Fukuda Noboru Fujino Taiki Higo Mitsuaki Isobe Chizuko Kamiya Seiya Kato Yasuki Kihara Koichiro Kinugawa Shintaro Kinugawa Shigetoyo Kogaki Issei Komuro Nobuhisa Hagiwara Minoru Ono Yuichiro Maekawa Shigeru Makita Yoshiro Matsui Shouji Matsushima Yasushi Sakata Yoshiki Sawa Wataru Shimizu Kunihiko Teraoka Miyuki Tsuchihashi-Makaya Hatsue Ishibashi-Ueda Masafumi Watanabe Michihiro Yoshimura Arata Fukusima Satoshi Hida Shungo Hikoso Teruhiko Imamura Hiroko Ishida Makoto Kawai Toshiro Kitagawa Takashi Kohno Satoshi Kurisu Yoji Nagata Makiko Nakamura Hiroyuki Morita Hitoshi Takano Tsuyoshi Shiga Yasuyoshi Takei Shinsuke Yuasa Teppei Yamamoto Tetsu Watanabe Takashi Akasaka Yoshinori Doi Takeshi Kimura Masafumi Kitakaze Masami Kosuge Morimasa Takayama Hitonobu Tomoike on behalf of the Japanese Circulation Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0910, (Released:2021-07-22)

参考文献数

687

被引用文献数

47

著者

Yuki Ikeda Junya Ako Koichi Toda Atsushi Hirayama Koichiro Kinugawa Yoshio Kobayashi Minoru Ono Takashi Nishimura Naoki Sato Takahiro Shindo Morimasa Takayama Satoshi Yasukochi Akira Shiose Yoshiki Sawa J-PVAD Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.87, no.5, pp.588-597, 2023-04-25 (Released:2023-04-25)

参考文献数

30

被引用文献数

16

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Background: The Impella®percutaneous left ventricular assist device has been available in Japan since 2017. This is the first large-scale registry study to analyze the efficacy and safety of Impella in Japanese patients with acute myocardial infarction with cardiogenic shock (AMICS).Methods and Results: The Japanese registry for Percutaneous Ventricular Assist Device (J-PVAD) has registered all consecutive Japanese patients treated with Impella. We extracted data for 593 AMICS patients from J-PVAD and analyzed 30-day survival and safety profiles. Overall 30-day survival was 63.1%. The 30-day survival of the Impella alone and Impella plus venoarterial extracorporeal membrane oxygenation (ECPELLA) groups was 80.9% and 45.7%, respectively. The Impella alone group was older and had a lower rate of cardiac arrest, milder consciousness disturbance, less inotrope use, lower serum lactate concentrations, higher B-type natriuretic peptide concentrations, and higher left ventricular ejection fraction (LVEF) than the ECPELLA group. Cox regression analysis revealed that older age and comorbid renal disturbance were common risk factors affecting 30-day mortality in both groups. Major adverse events were hemolysis (10.8%), hemorrhage/hematoma (7.6%), peripheral ischemia (4.4%), stroke (1.3%), and thrombosis (0.7%). LVEF improved in both groups during support.Conclusions: AMICS treatment with Impella showed favorable 30-day survival and safety profiles. The survival rate of patients treated with Impella alone was particularly high. Further studies are needed to improve outcomes of patients with ECPELLA support.

著者

Yuki Ikeda Junya Ako Koichi Toda Atsushi Hirayama Koichiro Kinugawa Yoshio Kobayashi Minoru Ono Takashi Nishimura Naoki Sato Takahiro Shindo Morimasa Takayama Satoshi Yasukochi Akira Shiose Yoshiki Sawa J-PVAD Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0476, (Released:2023-01-20)

参考文献数

30

被引用文献数

16

---

Background: The Impella®percutaneous left ventricular assist device has been available in Japan since 2017. This is the first large-scale registry study to analyze the efficacy and safety of Impella in Japanese patients with acute myocardial infarction with cardiogenic shock (AMICS).Methods and Results: The Japanese registry for Percutaneous Ventricular Assist Device (J-PVAD) has registered all consecutive Japanese patients treated with Impella. We extracted data for 593 AMICS patients from J-PVAD and analyzed 30-day survival and safety profiles. Overall 30-day survival was 63.1%. The 30-day survival of the Impella alone and Impella plus venoarterial extracorporeal membrane oxygenation (ECPELLA) groups was 80.9% and 45.7%, respectively. The Impella alone group was older and had a lower rate of cardiac arrest, milder consciousness disturbance, less inotrope use, lower serum lactate concentrations, higher B-type natriuretic peptide concentrations, and higher left ventricular ejection fraction (LVEF) than the ECPELLA group. Cox regression analysis revealed that older age and comorbid renal disturbance were common risk factors affecting 30-day mortality in both groups. Major adverse events were hemolysis (10.8%), hemorrhage/hematoma (7.6%), peripheral ischemia (4.4%), stroke (1.3%), and thrombosis (0.7%). LVEF improved in both groups during support.Conclusions: AMICS treatment with Impella showed favorable 30-day survival and safety profiles. The survival rate of patients treated with Impella alone was particularly high. Further studies are needed to improve outcomes of patients with ECPELLA support.

著者

Koichiro Kinugawa Yasushi Sakata Minoru Ono Shinichi Nunoda Koichi Toda Norihide Fukushima Akira Shiose Shogo Oishi Dai Yumino Teruhiko Imamura Miyoko Endo Yumiko Hori Koichi Kashiwa Kaoruko Aita Hiroyuki Kojin Yutaka Tejima Yoshiki Sawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.85, no.10, pp.1906-1917, 2021-09-24 (Released:2021-09-24)

参考文献数

21

被引用文献数

11

---

Destination therapy (DT) is the indication to implant a left ventricular assist device (LVAD) in a patient with stage D heart failure who is not a candidate for heart transplantation. The implantable LVAD has been utilized in Japan since 2011 under the indication of bridge to transplant (BTT). After almost 10 year lag, DT has finally been approved and reimbursed in May 2021 in Japan. To initiate the DT program in Japan, revision of the LVAD indication from BTT is necessary. Also, in-depth discussion of caregiver issues as well as end-of-life care is indispensable. For that purpose, we assembled a DT committee of multidisciplinary members in August 2020, and started monthly discussions via web-based communication during the COVID-19 pandemic. This is a summary of the consensus reached after 6 months’ discussion, and we have included as many relevant topics as possible. Clinical application of DT has just started, and we are willing to revise this consensus to meet the forthcoming issues raised during real-world clinical experience.

著者

Toshiyuki Nagai Takayuki Inomata Takashi Kohno Takuma Sato Atsushi Tada Toru Kubo Kazufumi Nakamura Noriko Oyama-Manabe Yoshihiko Ikeda Takeo Fujino Yasuhide Asaumi Takahiro Okumura Toshiyuki Yano Kazuko Tajiri Hiroyuki Matsuura Yuichi Baba Haruki Sunami Shingo Tsujinaga Yasutoshi Ota Keiko Ohta-Ogo Yusuke Ishikawa Hideo Matama Nobutaka Nagano Kimi Sato Kazushi Yasuda Yasushi Sakata Koichiro Kuwahara Tohru Minamino Minoru Ono Toshihisa Anzai on behalf of the Japanese Circulation Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0696, (Released:2023-03-10)

被引用文献数

17

著者

Teruhiko Imamura Koichiro Kinugawa Takashi Nishimura Koichi Toda Yoshikatsu Saiki Hiroshi Niinami Shinichi Nunoda Goro Matsumiya Motonobu Nishimura Hirokuni Arai Masanobu Yanase Norihide Fukushima Takeshi Nakatani Akira Shiose Ikuko Shibasaki Yasushi Sakata Minoru Ono J-MACS Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0264, (Released:2023-06-01)

参考文献数

18

被引用文献数

2

---

Background: Recently, destination therapy (DT) was approved in Japan, and patients ineligible for heart transplantation may now receive durable left ventricular assist devices (LVADs). Several conventional risk scores are available, but a risk score that is best to select optimal candidates for DT in the Japanese population remains unestablished.Methods and Results: A total of 1,287 patients who underwent durable LVAD implantation and were listed for the Japanese registry for Mechanically Assisted Circulatory Support (J-MACS) were eligible for inclusion. Finally, 494 patients were assigned to the derivation cohort and 487 patients were assigned to the validation cohort. According to the time-to-event analyses, J-MACS risk scores were newly constructed to predict 3-year mortality rate, consisting of age, history of cardiac surgery, serum creatinine level, and central venous pressure to pulmonary artery wedge pressure ratio >0.71. The J-MACS risk score had the highest predictability of 3-year death compared with other conventional scores in the validation cohort, including HeartMate II risk score and HeartMate 3 risk score.Conclusions: We constructed the J-MACS risk score to estimate 3-year mortality rate after durable LVAD implantation using large-scale multicenter Japanese data. The clinical utility of this scoring to guide the indication of DT should be validated in the next study.

著者

Rie Amao Teruhiko Imamura Yasuo Nakahara Satoko Noguchi Osamu Kinoshita Haruo Yamauchi Minoru Ono Nobuhiko Haga

出版者

一般社団法人 インターナショナル・ハート・ジャーナル刊行会

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.16-153, (Released:2016-11-09)

被引用文献数

3

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Advanced heart failure (HF) is sometimes complicated with brain impairment because of a microthrombosis caused by decreased left ventricular contraction or reduced brain circulation. Some patients may recover after left ventricular assist device (LVAD) implantation. However, little is known about the perioperative therapeutic strategy in patients suffering from such complications, particularly from a cardiac rehabilitation viewpoint. We report on a 58-year-old male patient with a previous history of poliomyelitis and a light paralysis in the left upper extremity, who suffered left hemiplegia with no evidence of stroke after hemodynamic deterioration. The combination therapy of perioperative cardiac rehabilitation and LVAD therapy improved his left hemiplegia as well as activities of daily living, and the patient was discharged on foot on postoperative day 72 after briefing the family on LVAD home management. Early initiation of cardiac rehabilitation before LVAD implantation may be a key for the smooth discharge and resocialization of patients suffering from brain impairment complicated with advanced HF.

著者

Teruhiko Imamura Koichiro Kinugawa Taro Shiga Naoko Kato Miyoko Endo Toshiro Inaba Hisataka Maki Masaru Hatano Atsushi Yao Yasunobu Hirata Takashi Nishimura Shunei Kyo Minoru Ono Ryozo Nagai

出版者

一般社団法人 インターナショナル・ハート・ジャーナル刊行会

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.53, no.6, pp.391-393, 2012 (Released:2012-12-18)

参考文献数

16

被引用文献数

7 9

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Hypervolemic hyponatremia is often complicated with advanced heart failure together with increased excretion of sodium by diuretics. Tolvaptan, an oral vasopressin-2-receptor antagonist, has been previously reported to improve congestion and correct hyponatremia through increased excretion of free water. However, there is little evidence concerning the administration of tolvaptan in patients with stage D heart failure. We experienced 2 patients with stage D heart failure who received 3.75 mg/day of tolvaptan to correct hyponatremia before ventricular assist device implantation. It may be useful, even for patients with stage D heart failure, to administer a low dose of tolvaptan to treat hyponatremia before ventricular assist device implantation to avoid a drastic alteration in serum sodium concentration perioperatively.

著者

Teruhiko Imamura Koichiro Kinugawa Masaru Hatano Takeo Fujino Toshiro Inaba Hisataka Maki Osamu Kinoshita Kan Nawata Shunei Kyo Minoru Ono Issei Komuro

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.78, no.9, pp.2259-2267, 2014-08-25 (Released:2014-08-25)

参考文献数

28

被引用文献数

17 48

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Background:Depressed hemodynamics stimulates arginine vasopressin (AVP) release, but the relationship between plasma AVP levels (P-AVP) and cardiac parameters, especially in patients with stage D heart failure (HF) receiving guideline-directed medical therapy, has not examined.Methods and Results:Data including P-AVP were obtained from 162 in-hospital patients with stage D HF and from 80 patients receiving ventricular assist device (VAD, n=46) or heart transplantation (HTx, n=34) at 3 months after surgery. In the HF group, considerably high P-AVP (5.9±6.1 pg/ml) negatively correlated with serum sodium concentration (S-Na, 135.3±5.8 mEq/L, r=–0.548 [P<0.01]) and cardiac index (CI, 2.2±0.5 L·min–1·m–2, r=–0.458 [P<0.01]). After VAD/HTx treatment, improvement in the CI (2.7±0.5 L·min–1·m–2[P<0.01] vs. HF) was accompanied by normalization of serum sodium concentration (S-Na; 138.2±2.0 mEq/L [P<0.01] vs. HF) and suppressed release of AVP (1.7±3.4 pg/ml [P<0.01] vs. HF). P-AVP positively correlated with only S-Na (r=0.454 [P<0.01]), whereas no correlation was observed with CI after VAD/HTx treatment. P-AVP ≥5.3 pg/ml well predicted poor 2-year survival in HF group (60% [P<0.01] vs. 90%).Conclusions:Low cardiac output stimulates AVP release via a non-osmotic process that results in hyponatremia and poor prognosis in patients with stage D HF. After sufficient recovery of cardiac output by cardiac replacement therapy, AVP release is suppressed and is mainly regulated by serum osmolality. (Circ J 2014; 78: 2259–2267)

著者

Teruhiko Imamura Koichiro Kinugawa Naoko Kato Hironori Muraoka Takeo Fujino Toshiro Inaba Hisataka Maki Osamu Kinoshita Masaru Hatano Shunei Kyo Minoru Ono

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.78, no.3, pp.625-633, 2014 (Released:2014-02-25)

参考文献数

34

被引用文献数

56 57

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Background: The continuous flow (CF) left ventricular assist device (LVAD) has replaced the pulsatile flow (PF) LVAD because of its advantages of better patient survival and higher quality of life. However, “late-onset right ventricular failure (RVF)” after CF LVAD implantation has emerged as an increasing concern, but little is known about the mechanism. Methods and Results: We retrospectively analyzed the 3-month hemodynamic and echocardiographic data from 38 consecutive patients who had received CF LVADs, and from 22 patients who had received PF LVADs. Late-onset RVF was defined as persistent right ventricular stroke work index (RVSWI) <4.0g/m2 at any rotation speed and after saline infusion test at 5 weeks after implantation of CF LVAD. Patients with late-onset RVF had significantly impaired exercise tolerance indicated by shorter 6-min walking distance and lower peak VO2, and worsened tricuspid regurgitation, together with enlargement of the RV under CF LVAD treatment (all P<0.05). Univariable analyses demonstrated that preoperative smaller LV diastolic diameter (LVDd) was the risk factor for late-onset RVF with a cutoff value of 64mm calculated by ROC analysis (area under curve, 0.925). In contrast, there was no correlation between preoperative LVDd and postoperative RVSWI in the PF LVAD group, though their preoperative background was worse than that of the CF group. Conclusions: In the setting of preoperative small LVDd, CF LVAD may cause late-onset RVF by leftward shift of the interventricular septum.  (Circ J 2014; 78: 625–633)

著者

Teruhiko Imamura Koichiro Kinugawa Minoru Ono Osamu Kinoshita Norihide Fukushima Akira Shiose Yoshiro Matsui Kenji Yamazaki Yoshikatsu Saiki Akihiko Usui Hiroshi Niinami Goro Matsumiya Hirokuni Arai Yoshiki Sawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-1215, (Released:2019-04-24)

参考文献数

35

被引用文献数

7

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Background:Hemocompatibility-related adverse events (HRAEs) are substantial issues in patients with left ventricular assist devices (LVADs). Atrial fibrillation (AF) is associated with worse prognosis in patients with heart failure (HF), but its effect on HRAEs following LVAD implantation remain uncertain.Methods and Results:Data from the Japanese Mechanically Assisted Circulatory Support registry of consecutive patients who received HeartMate II LVADs and were followed for 1 year were retrospectively reviewed. Among 190 patients, 23 had AF and 167 had sinus rhythm. The AF group had comparable baseline characteristics with the non-AF group except for their higher age (53 vs. 42 years, P<0.001). Following LVAD implantation, most cases of AF (73%) persisted. Antiplatelet therapy, anticoagulation therapy, and LVAD speed following LVAD implantation were comparable between groups (P>0.05 for all). The 1-year survival free from HRAEs was comparable between groups (83% vs. 76%, P=0.52). Event rates of the breakdown of HRAEs were comparable between groups except for a relatively higher rate of surgically managed pump thrombosis in the AF group (0.16 vs. 0.04, incidence rate ratio 3.75, 95% confidence interval 0.87–16.1, P=0.075). These trends still remained with propensity score-matched comparison.Conclusions:Existence of AF had no effect on the development of HRAEs following LVAD implantation. The need to aggressively treat AF before or after LVAD implantation needs further investigation.