Left ventricular diastolic dysfunction (LVDD) has prognostic significance in heart failure (HF). We aimed to assess the impact of LVDD grade stratified by the updated 2016 echocardiographic algorithm (DD2016) on post-discharge outcomes in patients admitted for acute HF and compare with the previous 2009 algorithm (DD2009).The study included 481 patients hospitalized for acute decompensated HF. Comprehensive echocardiography and LVDD evaluation were performed just before hospital discharge. The primary endpoint was a composite of cardiovascular death and readmission for HF. The concordance between DD2016 and DD2009 was moderate (κ = 0.44, P < 0.001); the reclassification rate was 39%. During the follow-up (median: 15 months), 127 (26%) patients experienced the primary endpoint. In the Kaplan-Meier analysis, Grade III in DD2016 showed a lower event-free survival rate than Grades I and II (log rank, P < 0.001 and P = 0.048, respectively) and was independently associated with a higher incidence of the primary endpoint than Grade I [hazard ratio 1.89; 95% confidence interval (CI) 1.17-3.04; P = 0.009]. Grade II or III in DD2016, reflecting elevation of left ventricular (LV) filling pressure, added an incremental predictive value of the primary endpoint to clinical variables irrespective of LV ejection fraction. DD2016 was comparable to DD2009 in predicting the endpoint (net reclassification improvement = 11%; 95% CI -7% to 30%, P = 0.23).Despite simplification of the algorithm for LVDD evaluation, the prognostic value of DD2016 for post-discharge cardiovascular events in HF patients was maintained and not compromised in comparison with DD2009.

Clinical endpoint

Concordance

10.1093/ehjci/jez082

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Citations (20)

Direct oral anticoagulant use and outcomes in adult patients with Fontan circulation: A multicenter retrospective cohort study

International Journal of Cardiology (2020)

Naoto Kawamatsu Tomoko Ishizu Tomoko Machino‐Ohtsuka Keita Masuda Hitoshi Horigome

Fontan Procedure

10.1016/j.ijcard.2020.11.024

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Citations (21)

Efficacy of Low-Dose Isoproterenol Infusion for the Exclusion of a Left Atrial Appendage Thrombus in Patients With Dense Spontaneous Echo Contrast Caused by Atrial Fibrillation

Circulation Journal (2023)

Tomoko Machino‐Ohtsuka Kentaro Minami Hiro Yamasaki Tomofumi Nakatsukasa Naoto Kawamatsu

In patients with atrial fibrillation (AF) and severe blood stasis in the left atrial appendage (LAA), dense spontaneous echo contrast (SEC) disturbs the distinct visualization of the LAA interior, thus making thrombus diagnosis inconclusive. We aimed to prospectively assess the efficacy and safety of a protocol for a low-dose isoproterenol (ISP) infusion to reduce SEC to exclude an LAA thrombus.

10.1253/circj.cj-23-0271

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Citations (0)

Different Impact of Changes in Left Ventricular Ejection Fraction Between Heart Failure Classifications in Patients With Acute Decompensated Heart Failure

Circulation Journal (2019)

Masayoshi Yamamoto Yoshihiro Seo Tomoko Ishizu Isao Nishi Yoshie Hamada‐Harimura

Left ventricular ejection fraction (LVEF) can dramatically change when the patient has acute decompensated heart failure (ADHF). We investigated the impact of LVEF and subsequent changes on prognosis in patients with ADHF through a prospective study.

10.1253/circj.cj-18-0881

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Citations (17)

Prognostic significance of persistent restrictive filling pattern after cardiac resynchronization therapy

Journal of Echocardiography (2014)

Masayoshi Yamamoto Yoshihiro Seo Tomoko Ishizu Naoto Kawamatsu Kimi Sato

Mace

Clinical endpoint

10.1007/s12574-014-0234-0

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Citations (3)

Reverse remodeling of the tricuspid valve complex by sinus rhythm restoration after catheter ablation

Journal of Cardiology (2023)

Tomofumi Nakatsukasa Tomoko Ishizu Kentaro Minami Naoto Kawamatsu Kimi Sato

Perimeter

10.1016/j.jjcc.2023.04.018

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Citations (1)

Features of Lead-Induced Tricuspid Regurgitation in Patients With Heart Failure Events After Cardiac Implantation of Electronic Devices ― A Three-Dimensional Echocardiographic Study ―

Circulation Journal (2020)

Hideki Nakajima Yoshihiro Seo Tomoko Ishizu Noriko Iida Kimi Sato

Lead-induced tricuspid regurgitation (TR) after cardiac implantable electronic device (CIED) implantation is not fully understood. This study aimed to reveal the features of lead-induced TR by 3-dimensional echocardiography (3DE) in patients with heart failure (HF) events after CIED implantation.

Lead (geology)

10.1253/circj.cj-20-0620

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Citations (11)

Qualitative and Quantitative Assessment of Atrial Functional Mitral Regurgitation: analysis from the REVEAL-AFMR registry

European Heart Journal - Cardiovascular Imaging (2024)

Azusa Murata Tomohiro Kaneko Masashi Amano Yukio Satô Yohei Ohno

The prevalence, characteristics, and prognosis of atrial functional mitral regurgitation (AFMR) based on severity remain unclear. No studies have systematically evaluated quantitative thresholds, such as effective regurgitant orifice area (EROA) or regurgitant volume, in relation to outcomes in AFMR. This multicenter study aimed to clarify the clinical implications of both qualitative and quantitative assessments of AFMR severity.

Functional mitral regurgitation

10.1093/ehjci/jeae288

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Application of 3-Dimensional Speckle Tracking Imaging to the Assessment of Right Ventricular Regional Deformation

Circulation Journal (2013)

Akiko Atsumi Tomoko Ishizu Yuri Kameda Masayoshi Yamamoto Yoshie Harimura

Background: The aim of this study was to carry out 3-dimensional speckle tracking imaging (3DSTI) of the right ventricle (RV) and evaluate RV regional wall deformation. Methods and Results: 3DSTI of the RV was performed in 35 normal subjects, 8 patients with arrhythmogenic right ventricular cardiomyopathy, and 8 patients with pulmonary arterial hypertension. Peak systolic area change ratio and regional contraction timing relative to global systolic time (time to peak strain/time to end-systole×100) were measured in each segment. Good-quality images were acquired of the inflow segment in 87%, apex in 87%, outflow in 57%, and septum in 94% of the 35 normal subjects. In normal subjects, peak systolic area change ratio of the inflow anterior wall was –41±14%; inflow inferior wall, –35±9%; apical anterior wall, –41±10%; apical inferior wall, –31±11%; outflow, –31±9%; and septum wall, –36±11%. Contraction timing of the apical anterior wall and septum wall were earlier than those of other segments. In patients with RV dysfunction, 3DSTI indicated low peak systolic area change ratio in the damaged area. Conclusions: RV 3DSTI indicated segmental heterogeneity in magnitude and timing of RV contraction. 3DSTI may be a promising modality for providing precise quantitative information on complex RV wall motion. (Circ J 2013; 77: 1760–1768)

Systole

Cardiac cycle

Apex (geometry)

Outflow

Inflow

10.1253/circj.cj-12-1445

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Citations (52)