High- Versus Low-Gradient Severe Aortic Stenosis: Demographics, Clinical Outcomes, and Effects of the Initial Aortic Valve Replacement Strategy on Long-Term Prognosis.

Autor:	Taniguchi T; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Morimoto T; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Shiomi H; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Ando K; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Kanamori N; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Murata K; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Kitai T; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Kawase Y; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Izumi C; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Miyake M; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Mitsuoka H; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Kato M; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Hirano Y; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Matsuda S; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Inada T; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Nagao K; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Murakami T; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Takeuchi Y; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Yamane K; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Toyofuku M; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Ishii M; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Minamino-Muta E; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Kato T; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Inoko M; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Ikeda T; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Komasa A; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Ishii K; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Hotta K; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Higashitani N; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Kato Y; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Inuzuka Y; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Maeda C; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Jinnai T; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Morikami Y; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Saito N; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Minatoya K; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.)., Kimura T; From the Department of Cardiovascular Medicine (T.T., H.S., S.M., E.M.-M., T. Kato, N.S., T. Kimura) and Department of Cardiovascular Surgery (K. Minatoya), Kyoto University Graduate School of Medicine, Japan; Hyogo College of Medicine, Nishinomiya, Japan (T. Morimoto); Kokura Memorial Hospital, Kitakyushu, Japan (K.A.); Shimada Municipal Hospital, Japan (N.K.); Shizuoka City Shizuoka Hospital, Japan (K. Murata); Kobe City Medical Center General Hospital, Japan (T.K.); Kurashiki Central Hospital, Japan (Y.K.); Tenri Hospital, Japan (C.I., M.M.); Kindai University, Nara Hospital, Higashiosaka, Japan (H.M.); Mitsubishi Kyoto Hospital, Kyoto, Japan (M.K.); Kindai University Hospital, Higashiosaka, Japan (Y.H.); Osaka Red Cross Hospital, Japan (T.I., K.N.); Koto Memorial Hospital, Higashiomi, Japan (T. Murakami); Shizuoka General Hospital, Japan (Y.T.); Nishikobe Medical Center, Kobe, Japan (K.Y.); Japanese Red Cross Wakayama Medical Center, Japan (M. T.); National Hospital Organization Kyoto Medical Center, Japan (M. Ishii); Kitano Hospital, Osaka, Japan (M. Inoko); Hikone Municipal Hospital, Japan (T.I.); Kansai Electric Power Hospital, Japan (A.K., K.I.); Hyogo Prefectural Amagasaki General Medical Center, Japan (K.H.); Japanese Red Cross Otsu Hospital, Japan (N.H., T.J.); Saiseikai Noe Hospital, Osaka, Japan (Y.K.); Shiga Medical Center for Adults, Moriyama, Japan (Y.I.); Hamamatsu Rosai Hospital, Japan (C.M.); and Hirakata Kohsai Hospital, Japan (Y.M.). taketaka@kuhp.kyoto-u.ac.jp.
Jazyk:	angličtina
Zdroj:	Circulation. Cardiovascular interventions [Circ Cardiovasc Interv] 2017 May; Vol. 10 (5).
DOI:	10.1161/CIRCINTERVENTIONS.116.004796
Abstrakt:	Background: There is considerable debate on the management of patients with low-gradient severe aortic stenosis (LG-AS), defined as aortic valve area <1 cm 2 with peak aortic jet velocity ≤4.0 m/s, and mean aortic pressure gradient ≤40 mm Hg. Methods and Results: In the CURRENT AS registry (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis), there were 2097 patients (initial aortic valve replacement [AVR] strategy: n=977, and conservative strategy: n=1120) with high-gradient severe aortic stenosis (HG-AS) and 1712 patients (initial AVR strategy: n=219, and conservative strategy: n=1493) with LG-AS. AVR was more frequently performed in HG-AS patients than in LG-AS patients (60% versus 28%) during the entire follow-up. In the comparison between the initial AVR and conservative groups, the propensity score-matched cohorts were developed in both HG-AS (n=887 for each group) and LG-AS (n=218 for each group) strata. The initial AVR strategy when compared with the conservative strategy was associated with markedly lower risk for a composite of aortic valve-related death or heart failure hospitalization in both HG-AS and LG-AS strata (hazard ratio, 0.30; 95% confidence interval, 0.25-0.37; P <0.001 and hazard ratio, 0.46; 95% confidence interval, 0.32-0.67; P <0.001, respectively). Among 1358 patients with LG-AS with preserved left ventricular ejection fraction, the initial AVR strategy was associated with a better outcome than the conservative strategy (adjusted hazard ratio, 0.37; 95% confidence interval, 0.23-0.59; P <0.001). Conclusions: The initial AVR strategy was associated with better outcomes than the conservative strategy in both HG-AS and LG-AS patients, although AVR was less frequently performed in LG-AS patients than in HG-AS patients. The favorable effect of initial AVR strategy was also seen in patients with LG-AS with preserved left ventricular ejection fraction. Clinical Trial Registration: URL: http://www.umin.ac.jp/ctr/index.htm. Unique identifier: UMIN000012140. (© 2017 American Heart Association, Inc.)
Databáze:	MEDLINE
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