About

Dr. Takako Araki is an Associate Professor in the Division of Endocrinology, Diabetes and Metabolism at the University of Minnesota. She is dedicated to quality improvement of pituitary perioperative patient care and the management of various pituitary disorders. Her research and clinical focus include advancing understanding and treatment of pituitary conditions, with a particular emphasis on perioperative care for patients undergoing pituitary surgery. Dr. Araki's work contributes to improving patient outcomes through both clinical practice and research in this specialized area of endocrinology.

Research topics

• Internal medicine
• Medicine
• Cardiology
• Intensive care medicine

Selected publications

• Evaluation of the PARACHUTE-HF trial: role of sacubitril/valsartan compared to enalapril on outcomes in patients with heart failure from Chagas’ disease

  Heart Failure Reviews · 2026-03-30

  articleOpen access
  PublisherDOI

• Two-Year Results of PROACTIVE-HF Trial Stratified by Left Ventricular Ejection Fraction

  Journal of Cardiac Failure · 2026-03-01

  articleOpen access

  BACKGROUND: In the PROACTIVE-HF trial, remote heart failure (HF) management using comprehensive vital signs and seated mean pulmonary artery pressure (mPAP) was safe and resulted in a low reported rate of HF hospitalization (HFH) and all-cause mortality (HFH/D) through 12 months. In this report, we extend the results from the PROACTIVE-HF study through 2 years, stratified by ejection fraction (EF). METHODS AND RESULTS: PROACTIVE-HF was a prospective, multicenter, open-label, single-arm trial evaluating the safety and efficacy of patient management using the Cordella PA pressure sensor system in patients with New York Heart Association class III symptoms, regardless of EF. In the first 24 months, the incidence of HF events (HFE)/D was 0.89 (95% CI 0.81-0.99) events per patient, driven by HFH. Patients with HF with reduced EF had greater HFE/D rates than those with HF with preserved EF (1.0 vs 0.8 events per patient, P = .048). CONCLUSIONS: For patients with HF experiencing moderate-to-severe symptoms, management using the Cordella PA sensor system was associated with low event rates and improved health status at 2 years, regardless of EF. Comprehensive remote monitoring of vital signs, seated PAP, and patient-reported symptoms via a digital platform supports sustained benefit for high-risk patients with HF.

  PublisherDOI

• The effect of percutaneous coronary intervention after extracorporeal cardiopulmonary resuscitation on survival for out of hospital cardiac arrest: a causal inference analysis

  Resuscitation Plus · 2025-09-24 · 1 citations

  articleOpen access

  Percutaneous coronary intervention (PCI) improves survival in acute coronary syndromes and has been used in recent randomized trials of extracorporeal cardiopulmonary resuscitation (ECPR). However, the role of PCI during ECPR for out-of-hospital cardiac arrest (OHCA) remains uncertain. We analyzed adult patients with OHCA from the Extracorporeal Life Support Organization (ELSO) Registry from January 2020 to December 2022 who underwent ECPR at high-volume centers. Patients were stratified by PCI receipt. We applied propensity-score weighting to balance covariates predicting the probability of receipt of PCI including year, age, sex, race, quantitative burden of comorbidities, CPR duration prior to ECMO flow start, initial cardiac arrest rhythm, and center-level case volume. The primary outcome was survival to hospital discharge. We estimated adjusted odds ratios (aORs) using multivariable logistic regression and inverse probability weighting (IPW). Among 576 adult OHCA patients who received ECPR, 138 (24.3%) received PCI. PCI patients were more likely to arrest at home (59.4% vs. 46.1%; p=0.049) and have higher a greater initial incidence rates of ventricular fibrillation (VF) as the first detected rhythm (68.1% vs. 48.9%; p<0.001). Survival to hospital discharge was similar between groups (PCI: 18.1%, non-PCI: 20.1%). Adjusted causal inference analyses, including multivariable logistic regression (OR 0.99, 95% CI: 0.56–1.75, p = 0.98), inverse probability weighting (OR 1.03, 95% CI: 0.58–1.82, p = 0.93), and augmented IPW models (OR 1.06, 95% CI: 0.58–1.93, p = 0.85), showed no statistically significant association between PCI and survival to hospital discharge. PCI was not associated with improved survival in adult ECPR patients. These findings highlight the need for further prospective studies to clarify the role of PCI in ECPR and identify patient populations that may benefit from this intervention.

  PublisherDOI

• MYCN Regulates Cardiomyocyte Proliferation, Metabolism, and Regeneration in the Mammalian Heart

  Circulation · 2025-09-02

  letter
  PublisherDOI

• Abstract Sun302: VASOPLEGIA IN PATIENTS TREATED WITH ECPR: RISK FACTORS, OUTCOMES AND TREATMENT STRATEGIES

  Circulation · 2025-11-03

  article

  Background: Vasoplegia is persistent hypotension or sustained vasopressor requirement despite adequate fluid resuscitation, typically in the setting of elevated cardiac output. Extracorporeal cardiopulmonary resuscitation (ECPR) improves survival in patients with refractory cardiac arrest. However, the transition from a prolonged low-flow state to restored circulation often precipitates vasoplegic syndrome and subsequent circulatory collapse. The risk factors and outcomes of vasoplegic shock in ECPR are poorly defined. Methods: We analyzed all patients with refractory cardiac arrest who underwent ECPR using peripheral VA ECMO cannulation at our center between 2015 and 2024. After excluding patients with severe bleeding or obstructive shock, a total of 367 patients were included in the analysis. Results: In the first 24 h post ECMO cannulation, we identified two clusters: one with higher fluid balance (FB) and greater pressor use (P), and another with lower FB and lower P (Cluster A: N = 152, mean FB = 5938 ml, mean P = 2.89 vs Cluster B: N=215, mean FB=712 ml, mean P=1.01). Cluster A was older (59.1 vs 55.5 y, p=0.006), had higher BMI (32.2 vs 29.9, p= 0.003), more frequent HTN (55.8% vs 40.8 %, p=0.007) and use of ACE/ARB/ARNI ( 45% vs 32% p=0.02), CCB (20.7% vs 9.6%, p 0.006) and diuretics ( 34.5 % vs 23.7%, p=0.039); had more acidemia (Ph 7.23 vs 7.28, p=.006 and bicarb 17.6 vs 19, p=.004), higher lactate (13.2 vs 9.7, p&lt;0.0001), lower temperature (92.4 vs 93.6, p=.04) and SVO2 (67.4 vs 70.6, p=.005), and higher need for IABP ( 69.7% vs 48.4% p&lt;.001) and was treated with higher ECMO flows (3.8 vs 3.6 p=.0003). Cluster A had lower survival rates (10.5% vs 51.1%, p&lt;.000001. Within cluster A, four quadrants were identified. The worst survival rates were in patients with high FB and high P (N=56,3.6% survival) followed by patients with high FB and low P (N=30, 6.7% survival) compared to patients with low FB and high P ( N=51, survival 17.6%) and patients with low FB and high p (N=15, survival 20%) (p=.049). Conclusions: Higher FB and increased P use within the first 24 h of ECMO cannulation were associated with worse survival in patients undergoing ECPR. This phenotype is linked to prior antihypertensive medication use and lactic acidosis. Notably, higher FB was linked to worse outcomes compared to high P use, within the vasoplegic phenotype, raising important considerations about the detrimental effect of positive fluid balance in this patient population.

  PublisherDOI

• Impact of SGLT2 inhibitors on long-term outcomes in TAVI patients with heart failure: a propensity-matched analysis

  Revista Española de Cardiología (English Edition) · 2025-11-01 · 2 citations

  article
  PublisherDOI

• Abstract 4359809: Effect of Subcutaneous (SC) Injection of Furosemide Compared with Intravenous (IV) Injection on Vital Signs in Healthy Volunteers

  Circulation · 2025-11-03

  article1st authorCorresponding

  Introduction: Furosemide (FUR) remains the cornerstone agent to decongest patients with heart failure. Given the challenges associated with intravenous (IV) administration, an 80mg/10mL buffered formulation has been developed (Furoscix) to be administered subcutaneously (SC) over a period of 5 hours. This has demonstrated similar bioavailability and clinical efficacy to FUR IV with minimal impact on blood pressure (BP) and heart rate (HR). SCP-111 (FUR SC) is a novel SC injection FUR formulation in development with a concentration of 80mg/mL, and demonstrated similar bioavailability, diuretic, and natriuretic effects to FUR IV. However, its potential effects on BP and HR remain unknown. Methods: Randomized, open-label, single-center, crossover study. Healthy volunteers were randomized 1:1 to either receive 80mg FUR IV given as two 40mg boluses separated by two 2 hours first or FUR SC 80 mg/mL as SC injection over 10 seconds. Systolic BP (SBP), diastolic BP (DBP), and HR were monitored at set time points for 12 hours and changes from baseline were calculated. Following a 3-day washout period, individuals received the opposite treatment, and the same evaluation was completed. Results: The mean±SD baseline SBP and DBP for the FUR SC and FUR IV groups were 123±13 / 78±8 vs. 124±17 / 78± 9mmHg. Baseline HR were 69±9 and 69±10bpm, respectively indicating no difference between the groups. Mean change in SBP over the 12-hour follow-up ranged from -1.8 to -10.3mmHg for FUR SC and 1.5 to -11.3mmHg for FUR IV. The mean change in DBP ranged from 1.8 to -4.0mmHg for FUR SC and 5.5 to -3.7mmHg for FUR IV. The mean change in heart rate over the follow-up period ranged from 2.2 to -5.3bpm for FUR SC and 7.5 to -2.3bpm for FUR IV (Figure 1) . Conclusion: There were no clinically meaningful changes in blood pressure and heart rate over the 12-hour monitoring period in response to either FUR SC or FUR IV. Furosemide 80mg/mL administered as a SC injection was safe with regards to its effects on BP and HR and may become a potential alternative to IV furosemide in the near future.

  PublisherDOI

• Racial differences in cardiac arrest survival: insights from Minnesota metro data and the University of Minnesota extracorporeal cardiopulmonary resuscitation cohort

  Resuscitation Plus · 2025-11-20

  articleOpen access

  The study explores the association between race, survival and neurological outcomes among out-of-hospital cardiac arrest (OHCA) patients listed in Minnesota metro and the University of Minnesota Extracorporeal Cardiopulmonary Resuscitation (UMN-ECPR) program. This retrospective study included OHCA patients with initial shockable rhythm from two distinct cohorts: the Minnesota metro CARES cohort, treated with conventional CPR and the UMN-ECPR database (2016- 2023). Race was categorized as white or non-white. Good neurological outcome was defined as a Cerebral-Performance-Category score of 1–2. Logistic regression analyses examined survival by race, with primary models adjusted for age and gender and exploratory models further adjusted for witnessed status, location, bystander CPR, return-of-spontaneous-circulation, CPR duration. Of 2,700 OHCA patients in the CARES cohort, primarily treated with conventional CPR, 16.5% were non-white. Compared to white patients, non-whites were younger (mean age 54.0 vs. 64.4 years), more often female (32.8% vs. 23.6%), and less likely to receive bystander CPR (52.2% vs. 60%). Non-white patients had lower age- and gender-adjusted odds of survival to discharge (OR: 0.64; 95% CI, 0.5–0.82; p<0.001) and favorable neurological outcome (OR: 0.48; 95% CI, 0.35–0.64; p<0.001). Among 414 ECPR patients (22.7% non-white), non-white patients were younger (mean age 51 vs. 58.8 years) with lower bystander CPR rates (65.2% vs. 74.8%). There were no significant differences in age- and gender-adjusted survival (OR: 1.17; 95% CI, 0.69-2; p=0.554) or neurological outcome (OR: 1.07; 95% CI, 0.61-1.88; p=0.818). Non-white race was linked to worse outcomes in the conventional CPR cohort but not in the ECPR cohort.

  PublisherDOI

• Comparison of Supine and Sitting Pulmonary Pressures in Ambulatory Heart Failure Patients Using the Novel Cordella Pulmonary Pressure System

  ESC Heart Failure · 2025-07-17 · 1 citations

  articleOpen access

  AIMS: The aim of this study is to examine the relationship between supine and seated pulmonary artery pressure (PAP) measurements using the CordellaTM HF management system (Cordella) in patients with heart failure (HF). METHOD AND RESULTS: Paired supine and seated PAP readings from the SIRONA 2 and PROACTIVE-HF trials were included. A total of 504 NYHA class III HF patients contributed 40 115 paired measurements. Mean supine mean PAP (mPAP) was 29.1 ± 11.6 mmHg compared with a mean seated mPAP of 22.1 ± 12.2 mmHg (supine-seated difference 7.1 ± 6.5 mmHg, correlation = 0.85; P < 0.001); mean supine sPAP was 44.4 ± 16.6 mmHg compared to a mean seated sPAP 35.4 ± 17.8 mmHg (supine-seated difference 9.0 ± 8.5 mmHg, correlation = 0.88; P < 0.001); and mean supine dPAP was 19.1 ± 9.5 mmHg compared to a mean seated dPAP of 13.9 ± 9.5 mmHg (supine-seated difference 5.2 ± 5.6 mmHg, correlation = 0.82; P < 0.001). Quartile analysis demonstrated that supine-seated differences were larger at lower mPAP levels and narrowed at higher pressures (P < 0.001). Seated mPAP trends showed modest increases prior to heart failure hospitalization. CONCLUSIONS: This study presents the largest paired comparison of supine and sitting PAP and demonstrates a high degree of correlation between seated and supine measures of PAP. Supine-seated differences may reflect venous capacitance and preload reserve, providing novel physiologic insights into HF phenotyping. Seated PAP measurements are a valid and reliable alternative to supine measurements for HF patients with PAP sensors. Given patient preference for seated measurements and their closer reflection of daily physiologic status, incorporating seated PAP into routine monitoring may enhance adherence and optimize remote HF management.

  PublisherOA PDFDOI

• Abstract 4365694: Impact of Sodium-Glucose Cotransporter-2 Inhibitors on Mortality and Cardiovascular Outcomes Following TAVR in Heart Failure Patients: A Propensity-Matched Cohort Study

  Circulation · 2025-11-03

  article

  Introduction/Background: SGLT2 inhibitors (SGLT2i) have demonstrated cardiovascular and renal benefits in patients with heart failure (HF), yet their effect in individuals undergoing transcatheter aortic valve replacement (TAVR) remains insufficiently characterized. Given the high prevalence of HF among TAVR recipients, we aimed to evaluate the long-term outcomes associated with SGLT2i use in this population. Research Question/Hypothesis: We hypothesized that SGLT2i use near the time of TAVR would be associated with reduced all-cause mortality and major cardiovascular events in patients with HF. Methods/Approach: Using the TriNetX Research Network, we conducted a multicenter retrospective cohort study including adults with HF who underwent TAVR between 2015 and 2025. Patients prescribed SGLT2i within 30 days of TAVR were 1:1 propensity score-matched to non-users based on demographics, comorbidities, medications, and laboratory data. Outcomes were assessed at 3 months, 6 months, 12 months, and 5 years. The primary outcome was all-cause mortality; secondary outcomes included myocardial infarction (MI), stroke, hospitalizations, arrhythmias, and renal events. Hazard ratios (HR) and odds ratios (OR) were calculated with 95% confidence intervals (CI). Results/Data: A total of 6,044 patients (3,022 in each group) were included. SGLT2i use was associated with significantly reduced all-cause mortality at 3 months (3.5% vs. 4.9%; HR 0.71; 95% CI, 0.55–0.92; P=0.006), 6 months (5.0% vs. 8.1%; HR 0.61; 95% CI, 0.50–0.76; P&lt;0.001), 12 months (7.3% vs. 10.5%; HR 0.71; 95% CI, 0.60–0.85; P&lt;0.001), and 5 years (10.7% vs. 20.6%; HR 0.59; 95% CI, 0.51–0.67; P&lt;0.001). At 5 years, SGLT2i use was also associated with lower incidence of MI (12.0% vs. 14.4%; OR 0.81; 95% CI, 0.70–0.94; P=0.007) and hospital/emergency visits (51.0% vs. 62.5%; OR 0.63; 95% CI, 0.56–0.69; P&lt;0.001). Stroke reduction was noted at 6 months (4.8% vs. 6.1%; OR 0.79; 95% CI, 0.62–0.99; P=0.041) but not sustained long term. There were no statistically significant differences in arrhythmia or renal event rates between cohorts. Conclusion(s): SGLT2i use in HF patients undergoing TAVR was independently associated with significantly lower mortality and fewer adverse cardiovascular outcomes over five years. These findings support early initiation of SGLT2i as part of post-TAVR medical therapy and warrant further prospective investigation

  PublisherDOI

Frequent coauthors

• Cindy M. Martin

  Houston Methodist

  54 shared

• Herbert J. Meiselman

  University of Southern California

  45 shared

• Valmiki Maharaj

  University of Minnesota

  41 shared

• Rebecca Cogswell

  University of Minnesota

  40 shared

• Kálmán Tóth

  University of Pecs

  37 shared

• Andrew Shaffer

  31 shared

• Gábor Késmárky

  University of Pecs

  30 shared

• Ranjit John

  University of Minnesota

  30 shared

Labs

• Araki LabPI

Awards & honors

• Minnesota Top Doctors Award 2024
• Pro Merito Award 2024, Hungarian Society of Cardiology
• Minnesota Top Doctors Award for Women 2024