Background:Very limited data exist on the outcomes of transcatheter aortic valve implantation (TAVI) since Japanese marketing approval of the first TAVI device.Methods and Results:The Kyoto ...University-related hospital Transcatheter Aortic Valve Implantation (K-TAVI) registry includes prospectively collected data from 6 participating hospitals in Japan. We included 302 patients with severe aortic stenosis who underwent TAVI using the SAPIEN XT balloon-expandable valve via transfemoral (TF; n=203, 67%) or transapical (TA; n=99, 33%) approach between October 2013 and September 2015. Device success rate, based on the Valve Academic Research Consortium-2 criteria, was very high in the TF (97.0%) and TA (99.0%) groups. The 30-day mortality rates were 1.5% and 1.0% in the TF and TA groups, respectively. Major complications included stroke (transient or persistent: 2.3%), annulus rupture (1.0%), coronary intervention (1.0%), major vascular complications (1.7%), and permanent pacemaker implantation (5.4%). The procedure times of the post-proctoring period (n=210) were decreased compared with those of the proctoring period (n=89) without affecting the clinical outcomes. The survival rates at 6 and 12 months were 96.9% and 92.5% in the TF group, and 93.9% and 91.8% in the TA group, respectively.Conclusions:The K-TAVI registry data revealed that the early outcomes of TAVI using the SAPIEN XT were favorable in real-world Japanese patients.
ABSTRACT Background : Adonis mongolica (Ranunculaceae) is one of the endemic plants in Mongolia and has been used as a medicinal herb in Mongolian traditional medicine to treat patients with ...congestive heart failure showing tachycardia and edema. Although the plant has been empirically used in the last three decades, the precise information regarding its cardiovascular profile is still limited. Methods : We assessed the cardiohemodynamic and electrophysiological profile of the water-soluble extract of A. mongolica using the guinea pig in vivo model (n = 4) and in vitro preparation (n = 5 - 17). In addition, the onset mechanism of the extract-induced effects on the heart rate and blood pressure in vivo (n = 4), and the atrial rate and contractile force in vitro (n = 4 - 5) were pharmacologically analyzed. Results : The extract exerted the positive chronotropic, negative dromotropic, and vasopressor effects in addition to the proarrhythmic action in vivo. Meanwhile, it modestly decreased the atrial rate and aortic tension but increased the atrial contractile force in vitro. The pretreatment of dl-propranolol and prazosin significantly suppressed the positive chronotropic and vasopressor actions induced by the extract in vivo, indicating that the extract increased the sympathetic tone. Also, liquid chromatography-mass spectrometry analysis showed that water-soluble extract of A. mongolica contained eight kinds of cardiac glycosides. Conclusions : These results indicate that cardiac glycosides in the water-soluble extract of A. mongolica may explain currently observed various cardiovascular effects.
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