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Perkiö Kato, N., Johansson, P., Okada, I., de Vries, A. E., Kinugawa, K., Strömberg, A. & Jaarsma, T. (2015). Heart Failure Telemonitoring in Japan and Sweden: A Cross-Sectional Survey. Journal of Medical Internet Research, 17(11), e258
Open this publication in new window or tab >>Heart Failure Telemonitoring in Japan and Sweden: A Cross-Sectional Survey
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2015 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 17, no 11, p. e258-Article in journal (Refereed) Published
Abstract [en]

Background: Telemonitoring of heart failure (HF) patients is increasingly discussed at conferences and addressed in research. However, little is known about actual use in specific countries. Objective: We aimed to (1) describe the use of non-invasive HF telemonitoring, (2) clarify expectations of telemonitoring among cardiologists and nurses, and (3) describe barriers to the implementation of telemonitoring in Japan and Sweden. Methods: This study used a cross-sectional survey of non-invasive HF telemonitoring. A total of 378 Japanese (120 cardiologists, 258 nurses) and 120 Swedish (39 cardiologists, 81 nurses) health care professionals from 165 Japanese and 61 Swedish hospitals/clinics nationwide participated in the study (210 in Japan and 98 in Sweden were approached). Data were collected between November 2013 and May 2014 with a questionnaire that was adapted from a previous Dutch study on telemonitoring. Results: The mean age of the cardiologists and nurses was 47 years and 41 years, respectively. Experience at the current position caring for HF patients was 19 years among the physicians and 15 years among the nurses. In total, 7 Japanese (4.2%) and none of the Swedish health care institutions used telemonitoring. One fourth (24.0%, 118/498) of the health care professionals were familiar with the technology (in Japan: 21.6%, 82/378; in Sweden: 30.0%, 36/120). The highest expectations of telemonitoring (rated on a scale from 0-10) were reduced hospitalizations (8.3 in Japan and 7.5 in Sweden), increased patient self-care (7.8 and 7.4), and offering high-quality care (7.8 and 7.0). The major goal for introducing telemonitoring was to monitor physical condition and recognize signs of worsening HF in Japan (94.1%, 352/374) and Sweden (88.7%, 102/115). The following reasons were also high in Sweden: to monitor effects of treatment and adjust it remotely (86.9%, 100/115) and to do remote drug titration (79.1%, 91/115). Just under a quarter of Japanese (22.4%, 85/378) and over a third of Swedish (38.1%, 45/118) health care professionals thought that telemonitoring was a good way to follow up stable HF patients. Three domains of barriers were identified by content analysis: organizational barriers "how are we going to do it?" (categories include structure and resource), health care professionals themselves "what do we need to know and do" (reservation), and barriers related to patients "not everybody would benefit" (internal and external shortcomings). Conclusions: Telemonitoring for HF patients has not been implemented in Japan or Sweden. However, health care professionals have expectations of telemonitoring to reduce patients hospitalizations and increase patient self-care. There are still a wide range of barriers to the implementation of HF telemonitoring.

Place, publisher, year, edition, pages
JMIR PUBLICATIONS, INC, 2015
Keywords
disease management; expectation; heart failure; implementation barriers; nurses; perception; physicians; telemedicine
National Category
Clinical Medicine Sociology
Identifiers
urn:nbn:se:liu:diva-123823 (URN)10.2196/jmir.4825 (DOI)000366179400012 ()26567061 (PubMedID)
Note

Funding Agencies|Japan Society for the Promotion Science [25893059]

Available from: 2016-01-11 Created: 2016-01-11 Last updated: 2017-12-01
Naoko, K., Koichiro, K., Teruhiko, I., Hironori, M., Hisataka, M., Toshiro, I., . . . Ryozo, N. (2014). Differential impacts of achieved heart rate and achieved dose of β-blocker on clinical outcomes in heart failure with and without atrial fibrillation [Letter to the editor]. International Journal of Cardiology, 173(2), 331-333
Open this publication in new window or tab >>Differential impacts of achieved heart rate and achieved dose of β-blocker on clinical outcomes in heart failure with and without atrial fibrillation
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2014 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 173, no 2, p. 331-333Article in journal, Letter (Other academic) Published
Abstract [en]

n/a

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Biomarker; Hospitalization; Mortality; Systolic heart failure
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-111175 (URN)10.1016/j.ijcard.2014.03.050 (DOI)000334508200048 ()24680244 (PubMedID)
Note

Correction in International Journal of Cardiology 176(2014)303, 10.1016/j.ijcard.2014.04.261

 

Available from: 2014-10-10 Created: 2014-10-10 Last updated: 2017-12-05Bibliographically approved
Kato, N., Jaarsma, T. & Kinugawa, K. (2014). Editorial Material: Impact of Comorbidities on Economic and Health Outcomes for Patients With Cardiovascular Disease. Circulation Journal, 78(3), 588-589
Open this publication in new window or tab >>Editorial Material: Impact of Comorbidities on Economic and Health Outcomes for Patients With Cardiovascular Disease
2014 (English)In: Circulation Journal, ISSN 1346-9843, E-ISSN 1347-4820, Vol. 78, no 3, p. 588-589Article in journal, Editorial material (Other academic) Published
Abstract [en]

n/a

Place, publisher, year, edition, pages
Japanese Circulation Society, 2014
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-105746 (URN)10.1253/circj.CJ-14-0056 (DOI)000332141100008 ()
Available from: 2014-04-07 Created: 2014-04-04 Last updated: 2017-12-05
Imamura, T., Kinugawa, K., Kato, N., Muraoka, H., Fujino, T., Inaba, T., . . . Ono, M. (2014). Late-onset right ventricular failure in patients with preoperative small left ventricle after implantation of continuous flow left ventricular assist device. Circulation Journal, 78(3), 625-633
Open this publication in new window or tab >>Late-onset right ventricular failure in patients with preoperative small left ventricle after implantation of continuous flow left ventricular assist device
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2014 (English)In: Circulation Journal, ISSN 1346-9843, E-ISSN 1347-4820, Vol. 78, no 3, p. 625-633Article in journal (Refereed) Published
Abstract [en]

Background: The continuous flow (CF) left ventricular assist device (LVAD) has replaced the pulsatile flow (PF) LVAD because of its advantages of better patient survival and higher quality of life. However, "late-onset right ventricular failure (RVF)" after CF LVAD implantation has emerged as an increasing concern, but little is known about the mechanism. Methods and Results: We retrospectively analyzed the 3-month hemodynamic and echocardiographic data from 38 consecutive patients who had received CF LVADs, and from 22 patients who had received PF LVADs. Late-onset RVF was defined as persistent right ventricular stroke work index (RVSWI) less than4.0 g/m(2) at any rotation speed and after saline infusion test at 5 weeks after implantation of CF LVAD. Patients with late-onset RVF had significantly impaired exercise tolerance indicated by shorter 6-min walking distance and lower peak (V) over dot O-2, and worsened tricuspid regurgitation, together with enlargement of the RV under CF LVAD treatment (all Pless than0.05). Univariable analyses demonstrated that preoperative smaller LV diastolic diameter (LVDd) was the risk factor for late-onset RVF with a cutoff value of 64 mm calculated by ROC analysis (area under curve, 0.925). In contrast, there was no correlation between preoperative LVDd and postoperative RVSWI in the PF LVAD group, though their preoperative background was worse than that of the CF group. Conclusions: In the setting of preoperative small LVDd, CF LVAD may cause late-onset RVF by leftward shift of the interventricular septum.

Place, publisher, year, edition, pages
Japanese Circulation Society, 2014
Keywords
Heart failure; Interventricular septum; Stroke work index; Survival
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-111177 (URN)10.1253/circj.CJ-13-1201 (DOI)000332141100017 ()24430596 (PubMedID)
Note

Funding Agencies|Fukuda Foundation for Medical Technology; Japanese Heart Foundation; Pfizer Health Research Foundation; Japan Society for the Promotion of Science [224943]

Available from: 2014-10-10 Created: 2014-10-10 Last updated: 2017-12-05Bibliographically approved
Kato, N., Jaarsma, T. & Ben Gal, T. (2014). Learning self-care after left ventricular assist device implantation. Current Heart Failure Reports, 11(3), 290-298
Open this publication in new window or tab >>Learning self-care after left ventricular assist device implantation
2014 (English)In: Current Heart Failure Reports, ISSN 1546-9530, E-ISSN 1546-9549, Vol. 11, no 3, p. 290-298Article in journal (Refereed) Published
Abstract [en]

The number of heart failure (HF) patients living with a left ventricular assist device (LVAD) as destination therapy is increasing. Successful long-term LVAD support includes a high degree of self-care by the patient and their caregiver, and also requires long-term support from a multidisciplinary team. All three components of self-care deserve special attention once an HF patient receives an LVAD, including activities regarding self-care maintenance (activities related both to the device and lifestyle), self-care monitoring (e.g., monitoring for complications or distress), and self-care management (e.g., handling alarms or coping with living with the device). For patients to perform optimal self-care once they are discharged, they need optimal education that focuses on knowledge and skills through a collaborative, adult learning approach.

Place, publisher, year, edition, pages
Springer, 2014
Keywords
Education; Heart failure; Left ventricular assist device; Maintenance; Management; Monitoring; Self-care
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-111211 (URN)10.1007/s11897-014-0201-0 (DOI)24831883 (PubMedID)2-s2.0-84906065019 (Scopus ID)
Available from: 2014-10-10 Created: 2014-10-10 Last updated: 2017-12-05Bibliographically approved
Imamura, T., Kinugawa, K., Minatsuki, S., Muraoka, H., Kato, N., Inaba, T., . . . Komuro, I. (2014). Urine sodium excretion after tolvaptan administration is dependent upon baseline serum sodium levels: a possible explanation for the improvement of hyponatremia with scarce chance of hypernatremia by a vasopressin receptor antagonist. International Heart Journal, 55(2), 131-137
Open this publication in new window or tab >>Urine sodium excretion after tolvaptan administration is dependent upon baseline serum sodium levels: a possible explanation for the improvement of hyponatremia with scarce chance of hypernatremia by a vasopressin receptor antagonist
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2014 (English)In: International Heart Journal, ISSN 1349-2365, E-ISSN 1349-3299, Vol. 55, no 2, p. 131-137Article in journal (Refereed) Published
Abstract [en]

Several studies have demonstrated that tolvaptan (TLV) can improve hyponatremia in advanced heart failure (BF) patients with rare chance of hypernatremia. However, changes in serum sodium concentrations (S-Na) in patients with or without hyponatremia during TLV treatment have not been analyzed. Ninety-seven in-hospital patients with decompensated HF who had received TLV at 3.75-15 mg/day for 1 week were enrolled. Among 68 "responders", who had achieved any increases in urine volume (UV) during the first day, urinary sodium excretion during 24 hours (U-NaEx(24)) increased significantly during one week of TLV treatment along with higher baseline S-Na (P less than 0.05 and r = 0.325). Considering a cut-off value (S-Na, 132 mEq/L; AUC, 0.711) for any increases in U-NaEx(24), we defined "hyponatremia" as S-Na less than 132 mEq/L. In hyponatremic responders (n = 25), S-Na increased significantly, although 1 week was not sufficient for normalization (125.8 +/- 5.0 versus 128.9 +/- 4.3 mEq/L, P less than 0.05), along with unchanged U-NaEx(24) (2767 +/- 2703 versus 2972 +/- 2950 mg/day, NS). In contrast, in normonatremic responders (n = 43), S-Na remained unchanged (136.6 +/- 3.1 versus 137.4 +/- 2.9 mEq/L, NS) along with increased U-NaEx(24) (2201 +/- 1644 versus 4198 +/- 3550 mg/day, P less than 0.05). TLV increased S-Na only in hyponatemic responders by way of pure aquaresis, but increased U-NaEx(24) only in nonnonatremic responders, which explains the scarcity of hypernatremia. Epithelial Na-channels in the distal nephrons, whose repression by TLV increases urinary sodium excretion, may be attenuated by reduced ATP-supply in worse hemodynamics under hyponatremia.

Place, publisher, year, edition, pages
International Heart Journal Association, 2014
Keywords
Heart failure; Vasopressin; Urine osmolality
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-111176 (URN)10.1536/ihj.13-221 (DOI)000336465600008 ()24632953 (PubMedID)
Note

Funding Agencies|Japan Society for the Promotion of Science [224943]; Japanese Heart Foundation; Japanese Association for Cerebro-Cardiovascular Disease Control and AstraZeneca; Pfizer Health Research Foundation

Available from: 2014-10-10 Created: 2014-10-10 Last updated: 2017-12-05Bibliographically approved
Imamura, T., Kinugawa, K., Kato, N., Minatsuki, S., Muraoka, H., Inaba, T., . . . Komuro, I. (2013). A case with recovery of response to tolvaptan associated with remission of acute kidney injury and increased urine osmolality. International Heart Journal, 54(2), 115-118
Open this publication in new window or tab >>A case with recovery of response to tolvaptan associated with remission of acute kidney injury and increased urine osmolality
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2013 (English)In: International Heart Journal, ISSN 1349-2365, E-ISSN 1349-3299, Vol. 54, no 2, p. 115-118Article in journal (Refereed) Published
Abstract [en]

Tolvaptan (TLV), a vasopressin type 2 receptor antagonist, has been demonstrated to be effective in patients with decompensated heart failure (HF) refractory to incremental doses of diuretics, but the responsiveness has not always been predictable. We have recently proposed that urine osmolality (U-OSM) is a valuable parameter for the prediction of responses to TLV, because U-OSM reflects the activity of the collecting ducts, where TLV plays its unique role. Acute kidney injury (AKI) is often associated with severe tubular dysfunction, including the collecting ducts, and in such cases a response to TLV may not be expected. We here experienced a patient with HF and AKI in whom TLV was not effective during AKI. We also observed recovery of responsiveness to TLV along with remission of AKI as well as increased U-OSM later on. We believe that this is the first report on the reversibility of the TLV response in relation to U-OSM.

Place, publisher, year, edition, pages
International Heart Journal Association, 2013
Keywords
Renal dysfunction; Vasopressin; Heart failure; Rejection
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-111186 (URN)10.1536/ihj.54.115 (DOI)000324452000011 ()23676373 (PubMedID)
Available from: 2014-10-10 Created: 2014-10-10 Last updated: 2017-12-05Bibliographically approved
Imamura, T., Kinugawa, K., Hatano, M., Kato, N., Minatsuki, S., Muraoka, H., . . . Komuro, I. (2013). Acute pulmonary vasoreactivity test with sildenafil or nitric monoxide before left ventricular assist device implantation. Journal of Artificial Organs, 16(3), 389-392
Open this publication in new window or tab >>Acute pulmonary vasoreactivity test with sildenafil or nitric monoxide before left ventricular assist device implantation
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2013 (English)In: Journal of Artificial Organs, ISSN 1434-7229, E-ISSN 1619-0904, Vol. 16, no 3, p. 389-392Article in journal (Refereed) Published
Abstract [en]

There has been no established medical therapy to ameliorate pulmonary hypertension (PH) owing to left heart disease (LHD-PH). It has recently been shown that the left ventricular assist device (LVAD) can improve LHD-PH and therefore has the potential to become a major bridge tool for heart transplantation (HTx). However, some patients still have persistent PH even after LVAD treatment. It is essential to demonstrate the reversibility of end-organ dysfunction, including PH, prior to implantable LVAD treatment, especially in Japan, because implantable LVAD treatment is indicated only as bridge to transplantation. Here we report a patient with LHD-PH whose PH was demonstrated to be reversible by the acute pulmonary vasoreactivity test (APVT) with nitrogen monoxide (NO) and the phosphodiesterase-5 inhibitor sildenafil. Both inhaled NO and sildenafil reduced pulmonary vascular resistance, but pulmonary capillary wedge pressure was increased by NO, which was conversely decreased under increased cardiac output by sildenafil. After the patient was listed as an HTx recipient, pulmonary vascular resistance recovered down to an acceptable range with LVAD treatment. Based on these findings, we suggest that the APVT with sildenafil may be a useful and safe tool to predict improvement of PH after LVAD treatment.

Place, publisher, year, edition, pages
Springer Verlag (Germany), 2013
Keywords
Heart failure; Transplantation; Pulmonary hypertension; Out of proportion
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-111181 (URN)10.1007/s10047-013-0706-4 (DOI)000325183500016 ()23559349 (PubMedID)
Available from: 2014-10-10 Created: 2014-10-10 Last updated: 2017-12-05
Imamura, T., Kinugawa, K., Hatano, M., Kato, N., Minatsuki, S., Muraoka, H., . . . Nagai, R. (2013). Bosentan improved persistent pulmonary hypertension in a case after implantation of a left ventricular assist device. Journal of Artificial Organs, 16(1), 101-104
Open this publication in new window or tab >>Bosentan improved persistent pulmonary hypertension in a case after implantation of a left ventricular assist device
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2013 (English)In: Journal of Artificial Organs, ISSN 1434-7229, E-ISSN 1619-0904, Vol. 16, no 1, p. 101-104Article in journal (Refereed) Published
Abstract [en]

No medical treatment has been established to ameliorate pulmonary hypertension (PH) due to left heart disease. Heart transplantation (HTx) is thus far the definitive therapy for stage D heart failure, but concomitant PH is one of the major risk factors for death after HTx. Recently, implantation of a left ventricular assist device (LVAD) has been reported to improve PH and has become a major bridge tool for HTx. We experienced a rare case with persistent PH even after the implantation of a continuous-flow LVAD. The administration of an endothelin receptor antagonist, bosentan, significantly decreased pulmonary vascular resistance. Combination therapy with LVAD implantation and anti-PH medication may be useful for patients with stage D heart failure complicated with severe PH.

Place, publisher, year, edition, pages
Springer, 2013
Keywords
Out of proportion; Postcapillary; Endothelin receptor antagonist
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-111187 (URN)10.1007/s10047-012-0662-4 (DOI)000316359400013 ()23015200 (PubMedID)
Available from: 2014-10-10 Created: 2014-10-10 Last updated: 2017-12-05Bibliographically approved
Jaarsma, T., Strömberg, A., Ben Gal, T., Cameron, J., Driscoll, A., Duengen, H.-D., . . . Riegel, B. (2013). Comparison of self-care behaviors of heart failure patients in 15 countries worldwide. Patient Education and Counseling, 92(1), 114-120
Open this publication in new window or tab >>Comparison of self-care behaviors of heart failure patients in 15 countries worldwide
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2013 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 92, no 1, p. 114-120Article in journal (Refereed) Published
Abstract [en]

Objective

Clinicians worldwide seek to educate and support heart failure patients to engage in self-care. We aimed to describe self-care behaviors of patients from 15 countries across three continents.

Methods

Data on self-care were pooled from 5964 heart failure patients from the United States, Europe, Australasia and South America. Data on self-care were collected with the Self-care of Heart Failure Index or the European Heart Failure Self-care Behavior Scale.

Results

In all the samples, most patients reported taking their medications as prescribed but exercise and weight monitoring were low. In 14 of the 22 samples, more than 50% of the patients reported low exercise levels. In 16 samples, less than half of the patients weighed themselves regularly, with large differences among the countries. Self-care with regard to receiving an annual flu shot and following a low sodium diet varied most across the countries.

Conclusion

Self-care behaviors are sub-optimal in heart failure patients and need to be improved worldwide.

Practice implications

Interventions that focus on specific self-care behaviors may be more effective than general educational programs. Changes in some health care systems and national policies are needed to support patients with heart failure to increase their self-care behavior.

Place, publisher, year, edition, pages
Elsevier, 2013
Keywords
Self-care, International, Disease management, Heart failure, Cardiac
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-95952 (URN)10.1016/j.pec.2013.02.017 (DOI)000321483700017 ()
Available from: 2013-08-19 Created: 2013-08-12 Last updated: 2017-12-06
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4437-0260

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