著者

Shiro Nakahara Yuichi Hori Reiko Fukuda Hirotsugu Sato Hideyuki Aoki Tetsuya Ishikawa Yuji Itabashi Sayuki Kobayashi Isao Taguchi Yasuo Okumura

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-23-0073, (Released:2023-09-16)

参考文献数

25

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Background: Adverse atrial remodeling, including epicardial adipose tissue (EAT) deposition in the left atrium (LA), is implicated in atrial fibrillation (AF). Radiofrequency hotballoon (RHB) ablation can produce wide planar lesions because the balloon is highly compliant; however, chronic effects of RHB ablation on structural remodeling remain unknown. This clinical-experimental investigation characterized chronic effects of RHB ablation on EAT in persistent AF (PsAF).Methods and Results: The clinical study involved 91 patients (obese, n=30; non-obese, n=61) undergoing RHB ablation for PsAF. LA-EAT was assessed from computed tomography images obtained before ablation and 6 months later. Tissue effects of RHB ablation were explored in a chronic swine model. RHB ablation significantly reduced LA volume (mean [±SD] 177.7±29.7 vs. 138.4±29.6 mL; P<0.001) and LA-EAT volume (median [interquartile range] 22.0 [12.4–33.3] vs. 16.5 [7.9–25.8] mL; P<0.001). The reduction in EAT was significantly greater in the pulmonary vein (PV) antrum than in other LA regions (37.9% vs. 15.8%; P<0.001). The percentage reduction in PV antrum EAT was equivalent between obese and non-obese patients, as was the postablation success rate (73% vs. 70%; P=0.77). RHB ablation produced transmural lesions reaching the pigs’ epicardial fat region.Conclusions: RHB-based planar-transmural lesions altered the structurally remodeled LA, including EAT. Further studies are needed to determine whether factors other than PV isolation contribute to the clinical success of RHB ablation.

著者

Tomoaki Ukaji Tetsuya Ishikawa Hidehiko Nakamura Yukiko Mizutani Kouta Yamada Masatoshi Shimura Yuki Kondo Yohei Tamura Yuri Koshikawa Itaru Hisauchi Shiro Nakahara Yuji Itabashi Sayuki Kobayashi Isao Taguchi

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-22-0120, (Released:2023-03-15)

参考文献数

26

被引用文献数

1

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Background: The prognostic impact of CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HS scores on clinical outcomes after drug-eluting stent (DES) placement has not been fully elucidated.Methods and Results: The present study was a retrospective, non-randomized, single-center, and lesion-based study. Target lesion failure (TLF), comprising cardiac death, non-fatal myocardial infarction, and target vessel revascularization, occurred in 7.1% of 872 consecutive de novo coronary lesions in 586 patients. These patients were electively and exclusively treated by DESs from January 2016 to January 2022 until July 2022 with a mean (±SD) observational interval of 411±438 days. Multivariate Cox proportional hazard analysis revealed that CHA2DS2-VASc-HS scores ≥7 (hazard ratio [HR] 1.800; 95% CI 1.06–3.05; P=0.029) was a significant predictor of cumulative TLF among 24 variables evaluated. CHADS2 scores ≥2 (HR 3.213; 95% CI 1.32–7.80; P=0.010) and CHA2DS2-VASc scores ≥5 (HR 1.980; 95% CI 1.10–3.55; P=0.022) were also significant in the multivariate analysis. Pairwise comparisons of receiver operating characteristic curves for CHADS2 score ≥2, CHA2DS2-VASc score ≥5, and CHA2DS2-VASc-HS score ≥7 showed they were equivalent in terms of predicting the incidence of TLF, with areas under the curve of 0.568, 0.575, and 0.573, respectively.Conclusions: All 3 cardiocerebrovascular thromboembolism risk scores were strong predictors of the incidence of cumulative mid-term TLF after elective DES placement, with cut-off values of 2, 5, and 7, respectively, and equivalent prognostic impacts.

著者

Reiko Fukuda Tetsuya Ishikawa Yuki Kondo Masatoshi Shimura Yukiko Mizutani Shiro Nakahara Isao Taguchi

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.3, no.1, pp.66-67, 2021-01-08 (Released:2021-01-08)

参考文献数

2