著者
Takashi Matsumoto Shunsuke Kubo Masaki Izumo Shingo Mizuno Shinichi Shirai on behalf of the MitraClip Japan PMS Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-21-0309, (Released:2021-10-29)
参考文献数
16
被引用文献数
10

Background:The MitraClip NT System was approved for marketing in Japan on October 31, 2017, and a prospective, multi-center, single-arm Post-Marketing use Surveillance (PMS) study was launched in 2018. This is the first report of the Japan PMS study with 1-year subject outcomes.Methods and Results:A total of 500 patients were registered between April 2018 and January 2019. Patients with symptomatic chronic moderate-to-severe (3+) or severe mitral regurgitation (MR; 4+), MR with a Society of Thoracic Surgery (STS) replacement score of ≥8%, or presence of 1 pre-defined risk factor were enrolled. Primary outcome measures included acute procedural success (APS), and rate of Single Leaflet Device Attachment (SLDA) at 30 days. The overall cohort was elderly (77.9±9.48 years) with functional MR etiology in 71.6% of the subjects. The majority of subjects were New York Heart Association (NYHA) class III/IV (68.9%), with mean STS replacement score of 11.95±9.66%. The APS rate was 91.13% and the 30-day SLDA rate was 1.21%. Durable MR reduction was achieved with 88.1% of subjects at MR ≤2+ at 1 year. Significant improvement in the functional capacity was observed, with 93% of subjects at NYHA class I/II at 1 year.Conclusions:In the Japan PMS experience, the MitraClip procedure resulted in improvements in MR severity, with significantly improved functional outcomes. These results demonstrate safety and efficacy of MitraClip therapy in the eligible Japanese population.
著者
Yuichi Sawayama Shunsuke Kubo Masanobu Ohya Sachiyo Ono Hiroyuki Tanaka Takeshi Maruo Yoshihisa Nakagawa Kazushige Kadota
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-23-0529, (Released:2023-10-27)
参考文献数
25
被引用文献数
1

Background: Evidence is limited regarding long-term clinical outcomes after alcohol septal ablation (ASA) for patients with hypertrophic obstructive cardiomyopathy and its periprocedural predictive factors in Japan.Methods and Results: This retrospective observational study included 44 patients who underwent ASA between 1998 and 2022 in a single center. We evaluated the periprocedural change in variables and long-term clinical outcomes after the procedure. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure. The secondary outcome was all-cause death. Using multivariable Poisson regression with robust error variance, we predicted underlying periprocedural factors related to primary outcome development. ASA decreased the median pressure gradient at the left ventricular outflow tract from 88 to 33 mmHg and reduced moderate or severe mitral regurgitation (MR), present in 53% of patients before ASA, to 16%. Over a median 6-year follow-up, the cumulative incidence of the primary outcome at 5 and 10 years was 16.5% and 25.6%, respectively. After multivariable analysis, moderate or severe MR after ASA was significantly associated with the primary outcome (relative risk 8.78; 95% confidence interval 1.34–57.3; P=0.024). All-cause mortality after ASA was 15.1% and 28.9% at 5 and 10 years, respectively.Conclusions: This study presents long-term clinical outcomes after ASA in Japan. Moderate or severe MR after ASA was significantly associated with the composite of cardiovascular death or hospitalization for heart failure.
著者
Kazuhiro FUJIWARA Shunsuke KUBO Kensuke EIJIMA Ryo MATSUDA Akira YANO
出版者
The Society of Agricultural Meteorology of Japan
雑誌
農業気象 (ISSN:00218588)
巻号頁・発行日
vol.78, no.3, pp.101-112, 2022-07-10 (Released:2022-07-10)
参考文献数
26

We have improved a light-emitting diode artificial sunlight source system that we developed in 2013. The 2013 system can produce light with various spectral distributions for wavelengths of 380-940 nm that approximates those of ground-level sunlight and produce light with arbitrarily modified spectral distributions. Moreover, this system can produce time-varying light with different spectral distributions. However, this system’s utility is limited because the light it produces has low maximum irradiance and low time-stability for sunlight-effect research experiments. Hardware and software improvements to that system allow it to now produce a maximum irradiance of approximately 1.54 kW m-2 for 380-940 nm at a 7.1 cm2 light outlet with greater time stability and make it easier to produce time-varying light having a large number of different spectral distributions. First-step operational tests showed that this improved system can accurately produce single light with spectral irradiance distributions (SIDs) approximating: (1) SIDs of ground-level sunlight measured in Tokyo at two-hour intervals on a clear day; (2) various magnifications (1.33, 1.2, 1, 1/10, 1/100, and 1/1000 times) of a reference terrestrial solar SID, which is defined by the International Electrotechnical Commission; and (3) various geometric-shape SIDs as arbitrarily modified ones, except for a rectangular shape. For the second-step operational test, time-varying light with the three SIDs described above was produced in various sequences at three-second intervals. The third-step operational test verified the 30-min time stability of SID at the light outlet. Operational tests indicate that the improved system can facilitate various sunlight-effect research. Our improved system enables sunlight-effect research experiments that were previously impossible, such as investigations of naturally fluctuating sunlight effects on plant response, growth, and development. Moreover, experiments comparing the effects of ground-level sunlight spectral distribution and conventional artificial lamps on plant growth and development are now possible.
著者
Yoichi Takaya Teiji Akagi Hidehiko Hara Hideaki Kanazawa Yuji Ikari Akihiro Isotani Shinichi Shirai Shunsuke Kubo Takao Morikawa Toru Naganuma Mike Saji Shingo Kuwata Go Hiasa Yusuke Watanabe Masahiro Yamawaki Masao Imai Takashi Matsumoto Masanori Yamamoto Tsutomu Murakami Masahiko Asami Isamu Mizote Tsukasa Okai Hiroki Bota Hiroshi Ito
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-22-0048, (Released:2022-04-05)
参考文献数
18
被引用文献数
3

Background: Transcatheter mitral valve repair with the MitraClip system has been established in selected high-risk patients. The MitraClip procedure results in a relatively large iatrogenic atrial septal defect (iASD). This study aimed to investigate the prevalence and clinical course of iASD requiring transcatheter closure following the MitraClip procedure.Methods and Results: This study was conducted at all 59 institutions that perform transcatheter mitral valve repair with the MitraClip system in Japan. The data of patients on whom transcatheter iASD closure was performed were collected. Of the 2,722 patients who underwent the MitraClip procedure, 30 (1%) required transcatheter iASD closure. The maximum iASD size was 9±4 mm (range, 3–18 mm). The common clinical course of transcatheter iASD closure was hypoxemia with right-to-left shunt or right-sided heart failure with left-to-right shunt. Of the 30 patients, 22 (73%) required transcatheter closure within 24 h following the MitraClip procedure, including 12 with hypoxemia and 5 with right-sided heart failure complicated with cardiogenic shock. Of the 5 patients, 2 required mechanical circulatory support devices. Twenty-one patients immediately underwent transcatheter iASD closure, and hemodynamic deteriorations were resolved; however, 1 patient died without having undergone transcatheter closure.Conclusions: Transcatheter iASD closure was required in 1% of patients who underwent the MitraClip procedure. Many of these patients immediately underwent transcatheter iASD closure because of hypoxemia with right-to-left shunt or right-sided heart failure with left-to-right shunt.