Circulation Reports
Online ISSN : 2434-0790
Volume 3 , Issue 5
Showing 1-12 articles out of 12 articles from the selected issue
Original Articles
Aortic Disease
  • Michihiro Okuyama, Weihua Jiang, Lihua Yang, Venkateswaran Subramanian
    Subject area: Aortic Disease
    2021 Volume 3 Issue 5 Pages 259-266
    Published: May 10, 2021
    Released: May 10, 2021
    [Advance publication] Released: April 20, 2021
    Supplementary material

    Background:Ascending and abdominal aortic aneurysms (AAs) are asymptomatic, permanent dilations of the aorta with surgical intervention as the currently available therapy. Hippo-Yap signaling cascade plays a critical role in stem cell self-renewal, tissue regeneration and organ size control. By using XMU-MP-1, a pharmacological inhibitor of the key component of Hippo-Yap signaling, MST1/2, we examined the functional contribution of Hippo-Yap in the development of AAs in Angiotensin II (AngII)-infused hypercholesterolemic mice.

    Methods and Results:MST, p-MST, p-YAP, p-MOB and TAZ proteins in AngII-infused ascending and abdominal aortas were assessed by immunohistochemical and western blot analyses. To examine the effect of MST1/2 inhibition on AAs, western diet-fed low density lipoprotein (LDL) receptor −/− mice infused with AngII were administered with either vehicle or XMU-MP-1 for 5 weeks. Hippo-YAP signaling proteins were significantly elevated in AngII infused ascending and abdominal aortas. XMU-MP-1 administration resulted in the attenuation of AngII-induced ascending AAs without influencing abdominal AAs and aortic atherosclerosis. Inhibition of Hippo-YAP signaling also resulted in the suppression of AngII-induced matrix metalloproteinase 2 (MMP2) activity, macrophage accumulation, aortic medial hypertrophy and elastin breaks in the ascending aorta.

    Conclusions:The present study demonstrates a pivotal role for the Hippo-YAP signaling pathway in AngII-induced ascending AA development.

Ischemic Heart Disease
  • Mitsuhiro Takeuchi, Hideki Wada, Manabu Ogita, Daigo Takahashi, Yui Ok ...
    Subject area: Ischemic Heart Disease
    2021 Volume 3 Issue 5 Pages 267-272
    Published: May 10, 2021
    Released: May 10, 2021
    [Advance publication] Released: April 09, 2021

    Background:Cerebrovascular disease often coexists with coronary artery disease (CAD), and it has been associated with worse clinical outcomes in CAD patients. However, the prognostic effect of prior stroke on long-term outcomes in patients with acute coronary syndrome (ACS) is still unclear.

    Methods and Results:An observational cohort study of ACS patients who underwent emergency percutaneous coronary intervention (PCI) between January 1999 and May 2015 was conducted. Patients were divided into 2 groups according to their history of stroke. We evaluated both all-cause death and cardiac death. Of the 2,548 consecutive ACS patients in the current cohort, 268 (10.5%) had a history of stroke at the onset of ACS. Patients with a history of stroke were older and had a higher prevalence of comorbidities such as hypertension or renal deficiency. The cumulative incidences of all-cause death and cardiac death were significantly higher in patients with a history of stroke (both log-rank P<0.0001). Multivariate Cox hazard regression analysis showed that a history of stroke was significantly associated with the incidences of all-cause death (hazard ratio [HR] 1.49, 95% confidence interval [CI] 1.20–1.85, P=0.0004) and cardiac death (HR 1.41, 95% CI 1.03–1.93, P=0.03).

    Conclusions:About 10% of the ACS patients had a history of stroke and had worse clinical outcomes.

Myocardial Disease
  • Junya Komatsu, Ryu-ichiro Imai, Yoko Nakaoka, Koji Nishida, Shu-ichi S ...
    Subject area: Myocardial Disease
    2021 Volume 3 Issue 5 Pages 273-278
    Published: May 10, 2021
    Released: May 10, 2021
    [Advance publication] Released: April 06, 2021

    Background:Although atrial fibrillation (AF) is a well-known risk factor for embolic stroke in hypertrophic cardiomyopathy (HCM), there is a paucity of information derived from HCM patients who have experienced embolic stroke.

    Methods and Results:From 141 consecutive HCM patients who had been hospitalized between 2000 and 2018, the clinical characteristics and management of 86 patients with AF were analyzed retrospectively. The incidence of embolic stroke was 36% (n=31 patients). The median (interquartile range) age of embolic stroke was younger in male than female HCM patients (71 [64–80] vs. 83 [77–87] years, respectively; P=0.009). The prevalence of paroxysmal AF (74%) was significantly higher than that of chronic AF (26%) in 31 patients with embolic stroke (P=0.007). The CHADS2score in patients with embolic stroke was not particularly useful in predicting the occurrence of embolic stroke.

    Conclusions:One-third of HCM patients with AF developed embolic stroke, and male HCM patients were younger at the time of the embolic stroke than female HCM patients. The prevalence of paroxysmal AF was significantly higher than that of chronic AF in patients with AF and embolic stroke. Early introduction of anticoagulation therapy is recommended at the first documentation of paroxysmal AF.

Pulmonary Circulation
  • Yosuke Morimoto, Satoshi Ikeda, Yuki Yamagata, Ryo Kozu, Hiroaki Kawan ...
    Subject area: Pulmonary Circulation
    2021 Volume 3 Issue 5 Pages 279-285
    Published: May 10, 2021
    Released: May 10, 2021
    [Advance publication] Released: April 03, 2021

    Background:This study investigated factors related to quality of life (QoL) in patients with chronic thromboembolic pulmonary hypertension who completed balloon pulmonary angioplasty (BPA).

    Methods and Results:Patient QoL and living environment after BPA were evaluated prospectively using the 5-level EQ-5D questionnaire and International Physical Activity Questionnaire Environmental Module (IPAQ-E), respectively. Patients were mailed copies of both surveys. In addition, we reviewed patient charts and collected retrospective clinical data. Relationship between the clinical data and QoL and environmental living factors were investigated. Of the 33 subjects mailed the surveys, sufficient responses were obtained from 22 (71%). Spearman’s rank correlation coefficient showed that psychiatric disorders (r=−0.6865, P<0.01) and IPAQ-E Question 5 (r=0.5192, P=0.02), Question 6 (r=0.5265, P=0.02), and Question 13 (r=0.4552, P=0.04) were significantly correlated with EQ-5D scores after BPA.

    Conclusions:A living environment that was difficult to walk around was associated with a worse QoL. A multidisciplinary approach will be required to improve QoL even after completion of BPA treatment.

Valvular Heart Disease
  • Hiroshi Onoda, Hiroshi Ueno, Teruhiko Imamura, Yohei Ueno, Hiroyuki Ku ...
    Subject area: Valvular Heart Disease
    2021 Volume 3 Issue 5 Pages 286-293
    Published: May 10, 2021
    Released: May 10, 2021
    [Advance publication] Released: April 07, 2021

    Background:Patients with anemia have a poor prognosis following transcatheter aortic valve implantation (TAVI). Given the unique distribution of hemoglobin levels in the Japanese cohort, the optimal cut-off hemoglobin value may help stratify Japanese patients’ mortality following TAVI.

    Methods and Results:Data of patients who underwent TAVI were collected from the prospective multicenter Optimized transCathEter vAlvular iNtervention (OCEAN)-TAVI Registry. Receiver operating characteristic analysis was used to calculate a hemoglobin cut-off value to stratify 2-year mortality following TAVI. In all, 2,588 patients (mean [±SD] age 84.4±5.2 years, 795 men) were included in the study. Of these patients, 909 (35.1%) had anemia, which was defined as hemoglobin <10.9 g/dL for men and <10.4 g/dL for women. The presence of anemia, uniquely defined for the Japanese cohort, was independently associated with 2-year mortality following TAVI, with an odds ratio of 1.77 (95% confidence interval 1.39–2.25) adjusted for 14 other clinical variables.

    Conclusions:The existence of anemia, uniquely defined for the Japanese cohort, was associated with mid-term mortality following TAVI.

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